Provider Demographics
NPI:1124646542
Name:LUNN, MICHELLE E (LICSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:E
Last Name:LUNN
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:PO BOX 1164
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99210-1164
Mailing Address - Country:US
Mailing Address - Phone:509-251-9217
Mailing Address - Fax:
Practice Address - Street 1:203 N WASHINGTON ST STE 200
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-0254
Practice Address - Country:US
Practice Address - Phone:509-749-3993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-13
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW604847121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical