Healthcare Provider Details

I. General information

NPI: 1619896297
Provider Name (Legal Business Name): LORI SUE DOUGLAS LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 N WILBUR RD APT 16
SPOKANE VALLEY WA
99206-7600
US

IV. Provider business mailing address

2301 N WILBUR RD APT 16
SPOKANE VALLEY WA
99206-7600
US

V. Phone/Fax

Practice location:
  • Phone: 509-570-6617
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61136224
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: