Provider Demographics
NPI:1841691235
Name:LENTZ, LARAE LINDA (LMHCA)
Entity type:Individual
Prefix:MS
First Name:LARAE
Middle Name:LINDA
Last Name:LENTZ
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1813
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:WA
Mailing Address - Zip Code:99006-1813
Mailing Address - Country:US
Mailing Address - Phone:509-828-0021
Mailing Address - Fax:
Practice Address - Street 1:1817 E SPRINGFIELD AVE STE B
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-2913
Practice Address - Country:US
Practice Address - Phone:509-774-5750
Practice Address - Fax:509-474-0324
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60448947101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health