Provider Demographics
NPI:1104110147
Name:HAEG, TERESA LEE (LMHC)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:LEE
Last Name:HAEG
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 E 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203
Mailing Address - Country:US
Mailing Address - Phone:503-910-6571
Mailing Address - Fax:509-363-2762
Practice Address - Street 1:701 WEST 7TH AVE
Practice Address - Street 2:107 SUITE A
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204
Practice Address - Country:US
Practice Address - Phone:530-910-6571
Practice Address - Fax:509-363-2762
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60126092101YM0800X
WALH60309126101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health