| Revive Counseling Spokane, Pllc | |
|
901 N Monroe St Ste 200 Spokane WA 99201-2148 | |
| (509) 413-2950 | |
| (509) 241-1866 |
| Full Name | Revive Counseling Spokane, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 901 N Monroe St Ste 200, Spokane, Washington |
| Authorized Official Name and Position | Layne E Pavey (OWNER/MHP) |
| Authorized Official Contact | 5094132950 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Counseling Spokane, Pllc 2222 N Monroe St Spokane WA 99205-4545 Ph: (509) 413-2950 | Revive Counseling Spokane, Pllc 901 N Monroe St Ste 200 Spokane WA 99201-2148 Ph: (509) 413-2950 |
| NPI Number | 1316477805 |
|---|---|
| Provider Enumeration Date | 06/15/2017 |
| Last Update Date | 03/24/2024 |
| Certification Date | 03/24/2024 |
| Medicare PECOS PAC ID | 7719398510 |
|---|---|
| Medicare Enrollment ID | O20201130003100 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316477805 | NPI | - | NPPES |
| 2079260 | Medicaid | WA | |
| 1225556483 | Medicaid | WA | |
| 1700304920 | Medicaid | WA | |
| 1679873368 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Garret Leigh Mcquesten |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609246743 PECOS PAC ID: 7214293059 Enrollment ID: I20171109003192 |
| Provider Name | Laura Ann Berg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124473087 PECOS PAC ID: 0749545507 Enrollment ID: I20180525001274 |
| Provider Name | Layne E Pavey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225556483 PECOS PAC ID: 7810252384 Enrollment ID: I20180604002131 |
| Provider Name | Erik Keith Loraas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265871578 PECOS PAC ID: 5395031793 Enrollment ID: I20180626002316 |
| Provider Name | Sean D Ziegler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548609829 PECOS PAC ID: 9234427105 Enrollment ID: I20200309001171 |
| Provider Name | Jessie L Harse |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700304920 PECOS PAC ID: 6800207184 Enrollment ID: I20201117001083 |
| Provider Name | Heidi J Batt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740735224 PECOS PAC ID: 5294123881 Enrollment ID: I20211101002804 |
| Provider Name | Troy L Todd |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538520598 PECOS PAC ID: 8224481692 Enrollment ID: I20240201001947 |
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