Provider Demographics
NPI:1295916260
Name:SPANJER, LORENA (MA, LMHC)
Entity type:Individual
Prefix:MRS
First Name:LORENA
Middle Name:
Last Name:SPANJER
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:MRS
Other - First Name:LORENA
Other - Middle Name:
Other - Last Name:HERRERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LMHCA
Mailing Address - Street 1:404 BRADLEY BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-4500
Mailing Address - Country:US
Mailing Address - Phone:509-942-8872
Mailing Address - Fax:509-215-7350
Practice Address - Street 1:404 BRADLEY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4500
Practice Address - Country:US
Practice Address - Phone:509-942-8872
Practice Address - Fax:509-215-7350
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60338133101YM0800X
WALH60962650261QM0801X, 101YM0800X, 101Y00000X
WARC00059643101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2175261Medicaid