Provider Demographics
NPI:1427525534
Name:BUSCH, KATHERINE GRACE (MA, LMHCA, CDPT)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:GRACE
Last Name:BUSCH
Suffix:
Gender:F
Credentials:MA, LMHCA, CDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2207 W CARLISLE AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-3738
Mailing Address - Country:US
Mailing Address - Phone:509-638-3860
Mailing Address - Fax:
Practice Address - Street 1:5600 E 8TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-0220
Practice Address - Country:US
Practice Address - Phone:509-795-8327
Practice Address - Fax:509-535-2863
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60624664101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health