Provider Demographics
NPI:1649825597
Name:DEVLIN, COLLEEN K (LMSW)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:K
Last Name:DEVLIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 S PALOUSE HWY # C212
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-7154
Mailing Address - Country:US
Mailing Address - Phone:208-262-1710
Mailing Address - Fax:
Practice Address - Street 1:1044 NORTHWEST BLVD STE F
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2165
Practice Address - Country:US
Practice Address - Phone:208-676-9395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-32367101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health