Provider Demographics
NPI:1043993496
Name:HENKE, CHARLES (LICSW)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:HENKE
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:CHUCK
Other - Middle Name:
Other - Last Name:HENKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:8602 CRESTON LN
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-6464
Mailing Address - Country:US
Mailing Address - Phone:509-868-1242
Mailing Address - Fax:
Practice Address - Street 1:4005 N COOK ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-5879
Practice Address - Country:US
Practice Address - Phone:509-868-1242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA609247891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical