Provider Demographics
NPI:1710432893
Name:KALUZA, JESSICA (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:KALUZA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 W NORA AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-4848
Mailing Address - Country:US
Mailing Address - Phone:509-688-4844
Mailing Address - Fax:
Practice Address - Street 1:16914 N TAMARAC LN
Practice Address - Street 2:
Practice Address - City:NINE MILE FALLS
Practice Address - State:WA
Practice Address - Zip Code:99026-9478
Practice Address - Country:US
Practice Address - Phone:509-688-4844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-18
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60831346101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health