Provider Demographics
NPI:1871650630
Name:LEVAN, ERIN RAE (MED, LMHC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:RAE
Last Name:LEVAN
Suffix:
Gender:F
Credentials:MED, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 E 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-2511
Mailing Address - Country:US
Mailing Address - Phone:509-953-5134
Mailing Address - Fax:877-895-3965
Practice Address - Street 1:59 E QUEEN AVE
Practice Address - Street 2:SUITE 113
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-1430
Practice Address - Country:US
Practice Address - Phone:509-953-5134
Practice Address - Fax:877-895-3965
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009966101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health