Provider Demographics
NPI:1124009980
Name:HOPKINS, CHARLES RAY (LMHC)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:RAY
Last Name:HOPKINS
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1427 W NORTHWEST BLVD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-4346
Mailing Address - Country:US
Mailing Address - Phone:509-641-3285
Mailing Address - Fax:509-413-2856
Practice Address - Street 1:1427 W NORTHWEST BLVD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-4346
Practice Address - Country:US
Practice Address - Phone:509-413-2856
Practice Address - Fax:509-413-2856
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00003594101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAA002OtherTRICARE INSURANCE
WAHU2807OtherASURIS HEALTHCARE