NPIMap

Organization Active NPI

Icard, P.L.L.C.

  • Clinical Psychologist
  • Spokane, WA
National Provider Identifier
1073655940
Registry record updated Jun 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY00002566 Issued in WA
Legal business name
ICARD, P.L.L.C.
Practice address
701 W 7TH Ave
Suite 130
Spokane, WA 99204-2843
Phone
(509) 869-3809
Fax
(509) 838-1163
NPI assigned
Feb 13, 2007
Last updated
Jun 12, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2017

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

Authorized official

Name
Dr. Elizabeth A Pechous, PHDNPI 1265575088
Title
Cofounder/Clinical Director
Phone
(509) 869-3809

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY00002566 WA Primary
Speech-Language Pathologist 235Z00000X LL00004374 WA

Addresses

Primary practice location

701 W 7TH Ave
Suite 130
Spokane, WA 99204-2843

Mailing address

701 W 7TH Ave
Suite 130
Spokane, WA 99204-2843
Phone (509) 869-3809

Other identifiers 1

IdentifierTypeStateIssuer
2077792MedicaidWA

Other names 1

  • Inland Center for Autism & Related Disorders, P.L.L.C. Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120104000491 WA Part B Supplier - Clinic/Group Practice 9436325982 Receives reassigned benefits from 3 practitioners
Practice locations: Spokane, WA

National Provider Directory

National Provider Directory

Locations

701 W 7th Ave
Ste 130
Spokane, WA 99204
Phone (509) 838-3932

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497225600000",
    "number": "1073655940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W 7TH AVE",
            "address_2": "SUITE 130",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042843",
            "telephone_number": "509-869-3809",
            "fax_number": "509-838-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W 7TH AVE",
            "address_2": "SUITE 130",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042843",
            "telephone_number": "509-869-3809",
            "fax_number": "509-838-1163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICARD, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2017-06-12",
        "status": "A",
        "authorized_official_last_name": "PECHOUS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "COFOUNDER/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "509-869-3809",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00002566",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00004374",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2077792",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Inland Center for Autism & Related Disorders, P.L.L.C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jun 12, 2017; 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.