Tahtanka Bear Eagle, MSW, LICSW

Clinical Social Worker · Moses Lake, WA

Individual Active NPI

NPI number 1215483821

Practice location

840 E Plum St
Moses Lake, WA 98837-1874
Phone
(509) 765-9239
Fax
(509) 633-2148

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NPI record

NPI
1215483821
Entity type
Individual (Type 1)
Enumeration date
September 1, 2016
Last updated
January 7, 2020
Certified
January 7, 2020
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Clinical Social Worker Primary 1041C0700X LW60717495 WA
Mental Health Counselor 101YM0800X SC60137902 WA

Mailing address

PO Box 1057
Moses Lake, WA 98837-0160
Phone
(509) 765-9239
Fax
(509) 765-1582

Other practice locations (1)

  • 21 Colville St, Nespelem, WA 99155 · (509) 634-2600

About Tahtanka Bear Eagle

Tahtanka Bear Eagle, MSW, LICSW is a healthcare provider registered in the NPI registry with the primary taxonomy Clinical Social Worker (code 1041C0700X). The practice location is 840 E Plum St, Moses Lake, WA 98837-1874. The NPI number 1215483821 was assigned on September 1, 2016 and the record was last updated on January 7, 2020.

Tahtanka Bear Eagle lists 2 licenses in the registry: #LW60717495 (WA) for Clinical Social Worker; #SC60137902 (WA) for Mental Health Counselor. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Tahtanka Bear Eagle, MSW, LICSW?

The NPI number is 1215483821.

What is the phone number of Tahtanka Bear Eagle?

The phone number listed for the practice location is (509) 765-9239.

Where is Tahtanka Bear Eagle located?

840 E Plum St, Moses Lake, WA 98837-1874.

What is the taxonomy code for Tahtanka Bear Eagle?

The primary taxonomy code is 1041C0700X – Clinical Social Worker; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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