DOMINIC MARCILLA (NPI# 1144784737) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144784737 |
| Entity Type | Individual |
| Full Name | DOMINIC MARCILLA |
| Credential | CO60930415 |
| Practice Address |
312 W 8th Ave Spokane WA 99204-2506 |
| Practice Telephone | 5093159791 |
| Mailing Telephone | 5093159791 |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2019-01-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CO60930415 | WA | Behavioral Health & Social Service Providers |
| Street Address |
312 W 8TH AVE |
| City | SPOKANE |
| State | WA |
| Zip Code | 99204-2506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104957323 | Community Detox Services of Spokane | Substance Abuse Rehabilitation Facility | 312 W 8th Ave, Spokane, WA 99204-2506 | 2007-03-08 |
| 1053944595 | Sheila Marie Wood | Counselor | 312 W 8th Ave, Spokane, WA 99204-2506 | 2020-02-12 |
| 1124668298 | Stanley William Hough | Counselor | 312 W 8th Ave, Spokane, WA 99204-2506 | 2020-01-07 |
| 1619517786 | Ira Robert Davis Jr. | Counselor | 312 W 8th Ave, Spokane, WA 99204-2506 | 2020-01-07 |
| 1720638299 | Karen Elaine Henderson | Peer Specialist | 312 W 8th Ave, Spokane, WA 99204-2506 | 2019-09-17 |
| 1851858187 | Bobbi Manley | Counselor | 312 W 8th Ave, Spokane, WA 99204-2506 | 2019-02-22 |
| 1083183495 | Melissa Denise Weipert | Social Worker | 312 W 8th Ave, Spokane, WA 99204 | 2018-11-14 |
| 1881162733 | Anthony Lee Williams | Counselor | 312 W 8th Ave, Spokane, WA 99204-2506 | 2018-11-08 |
| 1891262457 | Robert Knapp | Counselor | 312 W 8th Ave, Spokane, WA 99204-2506 | 2018-10-31 |
| 1982171542 | Chrystal Campbell | Counselor | 312 W 8th Ave, Spokane, WA 99204 | 2018-10-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982250957 | Megan Elizabeth Dibenedetto | Pharmacist | 105 West 8th Avenue, 350e, Spokane, WA 99204 | 2019-08-14 |
| 1619521168 | Evelyn R Cabon | Genetic Counselor, MS | 101 W. 8th Avenue Suite 1100, Spokane, WA 99204 | 2019-08-01 |
| 1346700655 | Christina Rose | Student in an Organized Health Care Education/Training Program | 120 W. 8th Avenue, Spokane, WA 99204 | 2019-03-22 |
| 1508339862 | Cody J French | Physical Therapist | Washington Outpatient Rehab, 507 S Washington, Spokane, WA 99204 | 2019-01-09 |
| 1730655598 | Washington Outpatient Rehabilitation, LLC | Physical Therapist | 507 S. Washington St., Suite 10, Spokane, WA 99204 | 2018-10-19 |
| 1013405547 | Joel James Hayden | Student in an Organized Health Care Education/Training Program | Providence Sacred Heart, 101 West 8th Avenue, Spokane, WA 99204 | 2018-04-30 |
| 1144694787 | Brooksjohnsonpllc | Dentist | 1004 S. Monroe Street, Ste 100, Spokane, WA 99204 | 2015-11-19 |
| 1497184196 | Kathalene M Cassels | Physician Assistant | 810 W. 5th Ave. Ste 510, Spokane, WA 99204 | 2013-11-04 |
| 1174880454 | Kelly E Wurzel | Psychiatry & Neurology | 624 E. Front Ave, Spokane, WA 99204 | 2012-04-11 |
| 1003190331 | Katie L Gomez | Nurse Practitioner | 805 W. 5th Ave, Suite 518, Spokane, WA 99204 | 2011-10-05 |
| Find all providers in zip 99204 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013517952 | Maria Escobedo | Counselor | 1321 N. Ash, Spokane, WA 99201 | 2020-10-29 |
| 1295342111 | Pamela Sue Russo | Counselor | 103 E First Ave, Spokane, WA 99202-1510 | 2020-09-24 |
| 1033728415 | Beyond Behavioral Health LLC | Counselor | 104 S Freya St Bldg Suite210, Spokane, WA 99202-4862 | 2020-07-30 |
| 1700400702 | Heather Hedum | Counselor | 104 S Freya St Ste 206, Spokane, WA 99202-4889 | 2020-06-04 |
| 1568004182 | Tracy L Dantzler | Counselor | 101 E Magnesium Rd Ste 101, Spokane, WA 99208-5901 | 2019-10-15 |
| 1568921534 | Megan Nicole Tackes | Counselor | 1508 W 6th Ave, Spokane, WA 99204-3409 | 2019-03-18 |
| 1942772637 | Cheryl Kay Cross | Counselor | 4214 N Cedar St, Spokane, WA 99205-1323 | 2018-12-19 |
| 1508337361 | Lisa Webb | Counselor | 2402 E Nebraska Ave, Spokane, WA 99208-2308 | 2018-12-05 |
| 1881162956 | Adam Patyk | Counselor | 820 W Jackson Ave Apt 3, Spokane, WA 99205-3335 | 2018-11-07 |
| 1003383159 | Sandra Kay Robinson | Counselor | New Horizons Care Centers, Inc., 701 E 3rd Street, Spokane, WA 99201 | 2018-10-26 |
| Find all providers in SPOKANE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.