NPIMap

Organization Active NPI

Palouse River Counseling Center

Doing business as Palouse River Counseling

  • Community/Behavioral Health Agency
  • Pullman, WA
National Provider Identifier
1063486272
Registry record updated Jan 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
009 Issued in WA
Legal business name
PALOUSE RIVER COUNSELING CENTER
Doing business as
Palouse River Counseling
Practice address
340 NE Maple St
Pullman, WA 99163-4120
Phone
(509) 334-1133
Fax
(509) 332-1608
NPI assigned
Feb 14, 2006
Last updated
Jan 13, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Mike Berney
Title
Executive Director
Phone
(509) 334-1133

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 009 WA Primary

Addresses

Primary practice location

340 NE Maple St
Pullman, WA 99163-4120

Mailing address

340 NE Maple St
Pullman, WA 99163-4120
Phone (509) 334-1133

Other identifiers 1

IdentifierTypeStateIssuer
7104177MedicaidWA

Other names 1

  • Palouse River Counseling Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040407000660 WA Part B Supplier - Clinic/Group Practice 5698768331 Receives reassigned benefits from 21 practitioners
Practice locations: Pullman, WA

National Provider Directory

National Provider Directory
Tax ID family
Palouse River Counseling3 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1009 S Mill St
Colfax, WA 99111
Phone (509) 397-3446

340 NE Maple St
Pullman, WA 99163
Phone (509) 334-1133

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389571200000",
    "number": "1063486272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 NE MAPLE ST",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991634120",
            "telephone_number": "509-334-1133",
            "fax_number": "509-332-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 NE MAPLE ST",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991634120",
            "telephone_number": "509-334-1133",
            "fax_number": "509-332-1608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALOUSE RIVER COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-14",
        "last_updated": "2014-01-13",
        "status": "A",
        "authorized_official_last_name": "BERNEY",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "509-334-1133",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WA",
            "license": "009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7104177",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palouse River Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pullman, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.