Provider Demographics
NPI:1366616104
Name:CATHOLIC FAMILY SERVICE COUNSELING PROGRAM
Entity type:Organization
Organization Name:CATHOLIC FAMILY SERVICE COUNSELING PROGRAM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCANN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:509-358-4250
Mailing Address - Street 1:12 E 5TH AVE
Mailing Address - Street 2:PO BOX 2253
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1309
Mailing Address - Country:US
Mailing Address - Phone:509-242-2308
Mailing Address - Fax:509-455-4988
Practice Address - Street 1:12 E 5TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1309
Practice Address - Country:US
Practice Address - Phone:509-242-2308
Practice Address - Fax:509-455-4988
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATHOLIC CHARITIES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-14
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA157251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health