1114046380 NPI number — MISS CORTNEY K RASLEY MA, NCC, LMHC

Table of content: MISS CORTNEY K RASLEY MA, NCC, LMHC (NPI 1114046380)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114046380 NPI number — MISS CORTNEY K RASLEY MA, NCC, LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RASLEY
Provider First Name:
CORTNEY
Provider Middle Name:
K
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
MA, NCC, LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114046380
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/08/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
316 W BOONE AVE
Provider Second Line Business Mailing Address:
SUITE 577
Provider Business Mailing Address City Name:
SPOKANE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99201-2354
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-939-9994
Provider Business Mailing Address Fax Number:
509-850-3638

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
316 W BOONE AVE
Provider Second Line Business Practice Location Address:
SUITE 577
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201-2354
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-939-9994
Provider Business Practice Location Address Fax Number:
509-850-3638
Provider Enumeration Date:
03/28/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  LH 60032260 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 213979 . This is a "N.C.C. CERTIFICATE NUMBER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 40036 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: LH 60032260 . This is a "MENTAL HEALTH COUNSELOR LICENSE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com