Provider Demographics
NPI:1043350234
Name:HOUSE, BETH ANN (LICSW)
Entity type:Individual
Prefix:MS
First Name:BETH
Middle Name:ANN
Last Name:HOUSE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 E EMPIRE AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-1719
Mailing Address - Country:US
Mailing Address - Phone:509-818-6700
Mailing Address - Fax:509-484-9233
Practice Address - Street 1:1521 E ILLINOIS AVE STE 109
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-5147
Practice Address - Country:US
Practice Address - Phone:509-818-6700
Practice Address - Fax:509-484-9233
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW600608061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical