Provider Demographics
NPI:1851801575
Name:SPIRO HEALING LLC
Entity Type:Organization
Organization Name:SPIRO HEALING LLC
Other - Org Name:SPIRO HEALING
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER & PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MALISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:TROJAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CCTP
Authorized Official - Phone:720-556-2449
Mailing Address - Street 1:2504 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97459-3230
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2504 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:OR
Practice Address - Zip Code:97459-3230
Practice Address - Country:US
Practice Address - Phone:720-556-2449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-08
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011007691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty