Provider Demographics
NPI:1417327883
Name:A BRIEF COUNSELING CENTER
Entity Type:Organization
Organization Name:A BRIEF COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:509-466-6632
Mailing Address - Street 1:9507 N DIVISION ST
Mailing Address - Street 2:THE HOLLAND BUILDING, SUITE A
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1248
Mailing Address - Country:US
Mailing Address - Phone:509-466-6632
Mailing Address - Fax:509-466-0117
Practice Address - Street 1:9507 N DIVISION ST
Practice Address - Street 2:THE HOLLAND BUILDING, SUITE A
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1248
Practice Address - Country:US
Practice Address - Phone:509-466-6632
Practice Address - Fax:509-466-0117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-29
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004487101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1127075Medicaid