Provider Demographics
NPI:1356768519
Name:NISHEK, SHOBA M (LICSW)
Entity type:Individual
Prefix:MS
First Name:SHOBA
Middle Name:M
Last Name:NISHEK
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 S MOUNT VERNON ST STE 202
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-4755
Mailing Address - Country:US
Mailing Address - Phone:509-570-6193
Mailing Address - Fax:
Practice Address - Street 1:3001 S MOUNT VERNON ST STE 202
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-4755
Practice Address - Country:US
Practice Address - Phone:509-570-6193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-26
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA607525001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical