Provider Demographics
NPI:1154713329
Name:HUMES, ELIZABETH (MA, LMHCA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:HUMES
Suffix:
Gender:F
Credentials:MA, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6712 KIMBALL DR. STE. 103
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:CA
Mailing Address - Zip Code:98335
Mailing Address - Country:US
Mailing Address - Phone:253-858-2224
Mailing Address - Fax:253-858-2254
Practice Address - Street 1:6712 KIMBALL DR. STE. 103
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:CA
Practice Address - Zip Code:98335
Practice Address - Country:US
Practice Address - Phone:253-858-2224
Practice Address - Fax:253-858-2254
Is Sole Proprietor?:No
Enumeration Date:2015-02-25
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC 60401192101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional