Provider Demographics
NPI:1790835189
Name:NORTH PINES COUNSELING PC
Entity Type:Organization
Organization Name:NORTH PINES COUNSELING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:NEILS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:509-927-1194
Mailing Address - Street 1:1005 PINES RD N
Mailing Address - Street 2:STE 250
Mailing Address - City:SPOKANE VLY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-4993
Mailing Address - Country:US
Mailing Address - Phone:509-927-1194
Mailing Address - Fax:509-927-8819
Practice Address - Street 1:1005 PINES RD N
Practice Address - Street 2:STE 250
Practice Address - City:SPOKANE VLY
Practice Address - State:WA
Practice Address - Zip Code:99206-4993
Practice Address - Country:US
Practice Address - Phone:509-927-1194
Practice Address - Fax:509-927-8819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA943103TC0700X
WALW000058431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB08694Medicare PIN