Organization Active NPI

Sagebrush Counseling PLLC

  • Clinical Social Worker
  • Spokane, WA
National Provider Identifier
1073076469
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SAGEBRUSH COUNSELING PLLC
Practice address
316 W Boone Ave
Spokane, WA 99201-2354
Phone
(509) 242-7200
Fax
(509) 593-4676
NPI assigned
Apr 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

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

Authorized official

Name
Kandi Arnhold
Title
Administration Services
Phone
(360) 770-2955

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

316 W Boone Ave
Spokane, WA 99201-2354

Mailing address

1702 W Main Ave
Spokane, WA 99201-1312
Phone (509) 242-7200

Other identifiers 1

IdentifierTypeStateIssuer
LW60876605OtherWAWA STATE DEPARTMENT OF LICENSING

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190619002515 WA Part B Supplier - Clinic/Group Practice 3375877756 Receives reassigned benefits from 1 practitioner
Practice locations: Spokane, WA

National Provider Directory

National Provider Directory

Locations

316 W Boone Ave
Spokane, WA 99201
Phone (509) 710-5726

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554940800000",
    "number": "1073076469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 W MAIN AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992011312",
            "telephone_number": "509-242-7200",
            "fax_number": "509-593-4676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 W BOONE AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012354",
            "telephone_number": "509-242-7200",
            "fax_number": "509-593-4676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGEBRUSH COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-11",
        "last_updated": "2019-04-11",
        "status": "A",
        "authorized_official_last_name": "ARNHOLD",
        "authorized_official_first_name": "KANDI",
        "authorized_official_title_or_position": "ADMINISTRATION SERVICES",
        "authorized_official_telephone_number": "360-770-2955"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE DEPARTMENT OF LICENSING",
            "identifier": "LW60876605",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.