Provider Demographics
NPI:1205208071
Name:LUCINDA J ROTTER MS PS LMHC COUNSELING
Entity Type:Organization
Organization Name:LUCINDA J ROTTER MS PS LMHC COUNSELING
Other - Org Name:LUCINDA J. ROTTER MS PS LMHC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT, OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LUCINDA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:ROTTER
Authorized Official - Suffix:
Authorized Official - Credentials:MS PS LMHC
Authorized Official - Phone:509-413-6078
Mailing Address - Street 1:5901 N LIDGERWOOD ST
Mailing Address - Street 2:SUITE 116
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-5095
Mailing Address - Country:US
Mailing Address - Phone:509-413-6078
Mailing Address - Fax:509-487-4834
Practice Address - Street 1:5901 N LIDGERWOOD ST
Practice Address - Street 2:SUITE 116
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-5095
Practice Address - Country:US
Practice Address - Phone:509-413-6078
Practice Address - Fax:509-487-4834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005827251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
1831208818Other1831208818