1437388469 NPI number — AMY KNIZEK M.ED, LMHC, CRC

Table of content: AMY KNIZEK M.ED, LMHC, CRC (NPI 1437388469)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437388469 NPI number — AMY KNIZEK M.ED, LMHC, CRC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KNIZEK
Provider First Name:
AMY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.ED, LMHC, CRC
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:
1437388469
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/18/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10013
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPOKANE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99209-1013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-570-4804
Provider Business Mailing Address Fax Number:
509-242-3002

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1212 N WASHINGTON ST
Provider Second Line Business Practice Location Address:
ONE ROCK POINTE, SUITE 306
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201-2403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-570-4804
Provider Business Practice Location Address Fax Number:
509-796-5254
Provider Enumeration Date:
07/12/2009

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: 101YP2500X , with the licence number:  LH60160750 , 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)





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