Provider Demographics
NPI:1811138142
Name:MCLUSKIE, GARY (MSW, LICSW)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:
Last Name:MCLUSKIE
Suffix:
Gender:M
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 1:11218 E 43RD AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-8610
Mailing Address - Country:US
Mailing Address - Phone:509-499-9266
Mailing Address - Fax:
Practice Address - Street 1:1420 N MULLAN RD
Practice Address - Street 2:SUITE L-5
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4366
Practice Address - Country:US
Practice Address - Phone:509-499-9266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-17
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WALW 600395031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health