Provider Demographics
NPI:1700439320
Name:HUSS, PETER CHRISTOPHER LACROIX (LICSW)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:CHRISTOPHER LACROIX
Last Name:HUSS
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 N HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-2410
Mailing Address - Country:US
Mailing Address - Phone:509-778-6878
Mailing Address - Fax:
Practice Address - Street 1:1212 N HOWARD ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2410
Practice Address - Country:US
Practice Address - Phone:509-778-6878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID394491041C0700X
WALW610894251041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALW61089425OtherPROFESSIONAL LICENSE
ID39449OtherPROFESSIONAL LICENSE