Healthcare Provider Details

I. General information

NPI: 1811556681
Provider Name (Legal Business Name): SUSAN P GALLAGHER LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SUSAN P BENSON

II. Dates (important events)

Enumeration Date: 06/06/2019
Last Update Date: 11/27/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 W BOONE AVE STE 656
SPOKANE WA
99201-2346
US

IV. Provider business mailing address

316 W BOONE AVE STE 656
SPOKANE WA
99201-2346
US

V. Phone/Fax

Practice location:
  • Phone: 509-242-7200
  • Fax:
Mailing address:
  • Phone: 509-242-7200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60928297
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: