Organization
SWIFTWATER COUNSELING
Active
Organization
SWIFTWATER COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLY MANKUS MSW (PROVIDER/OWNER)
(509) 961-0547
Entity
Organization
Contact information
Practice address
116 N OAKES AVE STE A2, CLE ELUM, WA 98922-1273
(509) 961-0547
Mailing address
PO BOX 346, NACHES, WA 98937-0346
(509) 961-0547
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548887383
—
WA
01
—
1770863987
INDIVIDUAL NPI
WA
05
—
2163968
—
WA
Enumeration date
06/27/2020
Last updated
10/13/2020
Update your record
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