Individual
CARISSA PEDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1408 W YORK AVE, SPOKANE, WA 99205-3567
(509) 991-2029
Mailing address
1408 W YORK AVE, SPOKANE, WA 99205-3567
(509) 991-2029
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LH61401717
WA
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LH61401717
STATE LICENSE
WA
Enumeration date
08/16/2018
Last updated
12/12/2024
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