Individual ProviderMaverick HemingerCounselorBehavioral Health & Social Service ProvidersPractice Address711 State Ave NE, Olympia, WA 98506-3984(360) 943-0780PECOS EnrollmentBased on the most recent information from CMS, provider Maverick Heminger does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1386177970Provider TypeIndividualFull NameHeminger, MaverickTitleMr.GenderMaleSole ProprietorNoEnumeration Date4/10/2017Last Updated4/6/2022Contact InformationPractice LocationPractice Address711 State Ave NE, Olympia, WA 98506-3984Phone(360) 943-0780FaxUnlisted FaxMailing LocationMailing Address711 State Ave NE, Olympia, WA 98506-3984Phone(360) 943-0780FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101Y00000XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseCG60631641WashingtonCode175T00000XDescriptionPeer SpecialistOther Service ProvidersLicenseUnlisted Issuer