Provider Demographics
NPI:1790290104
Name:BETH FERGIN PSYCHOTHERAPY, INC.
Entity Type:Organization
Organization Name:BETH FERGIN PSYCHOTHERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:FERGIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:509-455-7654
Mailing Address - Street 1:807 W 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2808
Mailing Address - Country:US
Mailing Address - Phone:509-455-7654
Mailing Address - Fax:509-455-4112
Practice Address - Street 1:807 W 7TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2808
Practice Address - Country:US
Practice Address - Phone:509-455-7654
Practice Address - Fax:509-455-4112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health