NPIMap

Organization Active NPI

Neurotherapy Northwest PLLC

  • Mental Health Counselor
  • Spokane Valley, WA
National Provider Identifier
1306269378
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
NEUROTHERAPY NORTHWEST PLLC
Practice address
12B N University Rd
Spokane Valley, WA 99206-5205
Phone
(509) 891-5900
NPI assigned
Jan 28, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Authorized official

Name
Shaelynn Nolan
Title
Billing Specialist
Phone
(509) 891-5900

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X LH00003406 WA
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X LH60387411 WA
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT00003756 WA

Addresses

Primary practice location

12B N University Rd
Spokane Valley, WA 99206-5205

Mailing address

12B N University Rd
Spokane Valley, WA 99206-5205
Phone (509) 891-5900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240228000379 WA Part B Supplier - Clinic/Group Practice 0345685566 Receives reassigned benefits from 3 practitioners
Practice locations: Spokane Valley, WA

National Provider Directory

National Provider Directory

Locations

12B N University Rd
Spokane Valley, WA 99206
Phone (509) 818-0086

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1390867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1306269378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12B N UNIVERSITY RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992065205",
            "telephone_number": "509-891-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12B N UNIVERSITY RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992065205",
            "telephone_number": "509-891-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROTHERAPY NORTHWEST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-28",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-07",
        "status": "A",
        "authorized_official_last_name": "NOLAN",
        "authorized_official_first_name": "SHAELYNN",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "509-891-5900"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00003406",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60387411",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00003756",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; 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.