Provider Demographics
NPI:1831208818
Name:ROTTER, LUCINDA JEAN (MS, LMHC)
Entity type:Individual
Prefix:MS
First Name:LUCINDA
Middle Name:JEAN
Last Name:ROTTER
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9507 N DIVISION ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1248
Mailing Address - Country:US
Mailing Address - Phone:509-466-6632
Mailing Address - Fax:509-466-0117
Practice Address - Street 1:9507 N DIVISION ST
Practice Address - Street 2:SUITE A
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1248
Practice Address - Country:US
Practice Address - Phone:509-466-6632
Practice Address - Fax:509-466-0117
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005827101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALH00005827OtherLICENSE