Provider Demographics
NPI:1801181078
Name:HUMPHREYS, SUMMER R (MS, LMHC, CMHS)
Entity Type:Individual
Prefix:
First Name:SUMMER
Middle Name:R
Last Name:HUMPHREYS
Suffix:
Gender:F
Credentials:MS, LMHC, CMHS
Other - Prefix:
Other - First Name:SUMMER
Other - Middle Name:R
Other - Last Name:KILLEBREW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LMHC
Mailing Address - Street 1:59 E QUEEN AVE
Mailing Address - Street 2:SUITE 214 D
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-1430
Mailing Address - Country:US
Mailing Address - Phone:509-340-3588
Mailing Address - Fax:
Practice Address - Street 1:59 E QUEEN AVE
Practice Address - Street 2:SUITE 214 D
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-1430
Practice Address - Country:US
Practice Address - Phone:509-340-3588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009383101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health