Provider Demographics
NPI:1639200371
Name:HASTINGS, JEFFREY TODD (MSW LMHC CDP)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:TODD
Last Name:HASTINGS
Suffix:
Gender:M
Credentials:MSW LMHC CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 W WAVERLY PL
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-3177
Mailing Address - Country:US
Mailing Address - Phone:509-280-6148
Mailing Address - Fax:
Practice Address - Street 1:9103 N DIVISION ST
Practice Address - Street 2:SUNCREST WELLNESS CENTER
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1251
Practice Address - Country:US
Practice Address - Phone:509-468-4770
Practice Address - Fax:509-468-4659
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00006283101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health