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MAHANAIM PSYCHOLOGY SERVICES PLLC NPI 1033525423


NPI Information

NPI: 1033525423
Provider Name: MAHANAIM PSYCHOLOGY SERVICES, PLLC
Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
110 W CRAWFORD ST STE F
DEER PARK, WA
ZIP 99006
Phone: (509) 276-5644
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MAHANAIM PSYCHOLOGY SERVICES, PLLC is a clinical psychologist in Deer Park, WA. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. MAHANAIM PSYCHOLOGY SERVICES, PLLC NPI is 1033525423. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

110 W CRAWFORD ST STE F
DEER PARK, WA
ZIP 99006-356
Phone: (509) 276-5644
Fax: (509) 780-4394

The provider's authorized official is Leslie G Brost .
The authorized official title is President Of Corporation/provider and has the following contact phone number (509) 276-5644.

The enumeration date for this NPI number is 7/7/2014 and was last updated on 11/19/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TC0700XPsychologistClinicalYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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