Provider Demographics
NPI:1790298610
Name:CHARMED COUNSELING PLLC
Entity Type:Organization
Organization Name:CHARMED COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOELEEN
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW, MAC
Authorized Official - Phone:509-768-6852
Mailing Address - Street 1:5915 S HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-9469
Mailing Address - Country:US
Mailing Address - Phone:509-768-6852
Mailing Address - Fax:509-232-5552
Practice Address - Street 1:5915 S HOLLY RD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99224-9469
Practice Address - Country:US
Practice Address - Phone:509-768-6852
Practice Address - Fax:509-232-5552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-14
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60649635261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2088953Medicaid