Provider Demographics
NPI:1578898730
Name:LARUE, CHRISTIN (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:
Last Name:LARUE
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17801 W. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272
Mailing Address - Country:US
Mailing Address - Phone:425-487-6285
Mailing Address - Fax:360-863-6842
Practice Address - Street 1:17801 W. MAIN STREET
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272
Practice Address - Country:US
Practice Address - Phone:425-487-6285
Practice Address - Fax:360-863-6842
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-06
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009736101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health