| Foundations Family Support Llc | |
|
922 S Cowley St Ste 9 Spokane WA 99202-1263 | |
| (509) 822-6777 | |
| (509) 822-6777 |
| Full Name | Foundations Family Support Llc |
|---|---|
| Speciality | Counselor |
| Location | 922 S Cowley St Ste 9, Spokane, Washington |
| Authorized Official Name and Position | Trevor Liebing (THERAPIST/OWNER) |
| Authorized Official Contact | 5098226777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Foundations Family Support Llc 922 S Cowley St Ste 9 Spokane WA 99202-1263 Ph: (509) 822-6777 | Foundations Family Support Llc 922 S Cowley St Ste 9 Spokane WA 99202-1263 Ph: (509) 822-6777 |
| NPI Number | 1083103238 |
|---|---|
| Provider Enumeration Date | 05/03/2018 |
| Last Update Date | 02/22/2023 |
| Certification Date | 02/22/2023 |
| Medicare PECOS PAC ID | 0547669731 |
|---|---|
| Medicare Enrollment ID | O20210519002809 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083103238 | NPI | - | NPPES |
| 2104214 | Medicaid | WA |
| Provider Name | Benjamin Charles Marlow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861651648 PECOS PAC ID: 2466764154 Enrollment ID: I20150709000981 |
| Provider Name | Shoba M Nishek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356768519 PECOS PAC ID: 0648511378 Enrollment ID: I20190408000750 |
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