Provider Demographics
NPI:1083199780
Name:PRYOR, INNESS (LMHC, SUDPT)
Entity Type:Individual
Prefix:
First Name:INNESS
Middle Name:
Last Name:PRYOR
Suffix:
Gender:F
Credentials:LMHC, SUDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MAIN ST STE 301
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-3404
Mailing Address - Country:US
Mailing Address - Phone:425-466-6231
Mailing Address - Fax:
Practice Address - Street 1:601 MAIN ST STE 301
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-3404
Practice Address - Country:US
Practice Address - Phone:425-466-6231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2021-08-25
Deactivation Date:2021-01-25
Deactivation Code:
Reactivation Date:2021-08-25
Provider Licenses
StateLicense IDTaxonomies
WA101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)