Provider Demographics
NPI:1033874581
Name:LAESCH, DANIEL JAMES (LMHCA)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:JAMES
Last Name:LAESCH
Suffix:
Gender:M
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 S ELM ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-3531
Mailing Address - Country:US
Mailing Address - Phone:217-417-4905
Mailing Address - Fax:
Practice Address - Street 1:808 S ELM ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-3531
Practice Address - Country:US
Practice Address - Phone:217-417-4905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61213342101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health