Healthcare Provider Details

I. General information

NPI: 1740228592
Provider Name (Legal Business Name): MICHELLE HELENE LINK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 04/02/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6002 N LIDGERWOOD ST
SPOKANE WA
99208-1124
US

IV. Provider business mailing address

3108 W MONTICELLO PL
SPOKANE WA
99205-5865
US

V. Phone/Fax

Practice location:
  • Phone: 509-482-4402
  • Fax:
Mailing address:
  • Phone: 509-326-0454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW00005377
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: