Provider Demographics
NPI:1952676900
Name:HESS-ALMUBARAK, ELIZABETH LEE (LPC, LMHC)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:LEE
Last Name:HESS-ALMUBARAK
Suffix:
Gender:F
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:538 KARIN AVE
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ID
Mailing Address - Zip Code:83501-3866
Mailing Address - Country:US
Mailing Address - Phone:208-305-2775
Mailing Address - Fax:
Practice Address - Street 1:538 KARIN AVE
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-3866
Practice Address - Country:US
Practice Address - Phone:208-305-2775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00010775101YM0800X
IDLPC-4101101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health