Provider Demographics
NPI:1467046334
Name:KNUTSON, CALLIE MARIE (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:CALLIE
Middle Name:MARIE
Last Name:KNUTSON
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12B N UNIVERSITY RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-5205
Mailing Address - Country:US
Mailing Address - Phone:509-891-5900
Mailing Address - Fax:
Practice Address - Street 1:12B N UNIVERSITY RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-5205
Practice Address - Country:US
Practice Address - Phone:509-891-5900
Practice Address - Fax:509-232-6646
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-22
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW615235821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty