Provider Demographics
NPI:1174112932
Name:HAINSWORTH, ANDREA (LMHCA)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:HAINSWORTH
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4713 E 40TH CT
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-1272
Mailing Address - Country:US
Mailing Address - Phone:509-981-3949
Mailing Address - Fax:
Practice Address - Street 1:140 S ARTHUR ST STE 510
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-2260
Practice Address - Country:US
Practice Address - Phone:509-761-9961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61079461101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor