Organization
LUTHERAN COMMUNITY SERVICES NORTHWEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELIA CLARK (CREDENTIALING SPECIALIST)
(541) 201-3973
Entity
Organization
Contact information
Practice address
3321 WEST KENNEWICK AVENUE, SUITE 150, KENNEWICK, WA 99336
(509) 735-6446
(509) 735-6449
Mailing address
3321 WEST KENNEWICK AVENUE, SUITE 150, KENNEWICK, WA 99336
(509) 735-6446
(509) 735-6449
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
WA
104100000X
Social Worker
—
WA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
11/06/2006
Last updated
03/29/2022
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