NPIMap

Mary Margaret Allen, CDPT

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Spokane, WA

NPI 1992261119 · NPPES record last updated Feb 12, 2019

Key facts

NPI
1992261119
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
60779570 (WA)
Practice address
1106 W Garland Ave
Spokane, WA 99205-2735
Phone
(509) 290-3286
NPI assigned
Feb 12, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
60779570WAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Goodwin Health Cafe, PLLC Current Accepting new patients

Locations

1106 W Garland Ave
Spokane, WA 99205
Phone (509) 290-3286

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 60779570 WA Yes

Addresses

Primary practice location

1106 W Garland Ave
Spokane, WA 99205-2735

Mailing address

4722 N Calispel St
Spokane, WA 99205-5106
Phone (509) 290-3286

Other identifiers

IdentifierTypeStateIssuer
60779570OtherWADEPARTMENT OF HEALTH

Other names

  • Mary M Allen Former name

Other providers in Spokane, WA

All providers in Spokane, WA · Addiction (Substance Use Disorder) Counselor in Washington

Sources for this page

Verify at the official NPI Registry.