Provider Demographics
NPI:1942448980
Name:GRUEN, ERICA RUTH (LMHC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:RUTH
Last Name:GRUEN
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 1:2426 S DISHMAN MICA RD STE 1
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-6409
Mailing Address - Country:US
Mailing Address - Phone:509-862-4719
Mailing Address - Fax:509-443-4760
Practice Address - Street 1:2426 S DISHMAN MICA RD STE 1
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-6409
Practice Address - Country:US
Practice Address - Phone:509-862-4719
Practice Address - Fax:509-443-4760
Is Sole Proprietor?:No
Enumeration Date:2009-01-29
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0058230Medicaid
IA05823OtherBCBS
WA2093931Medicaid