1730403247 NPI number — BETH ANNE FURY MS, LMHC, CDP, LCPC

Table of content: BETH ANNE FURY MS, LMHC, CDP, LCPC (NPI 1730403247)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730403247 NPI number — BETH ANNE FURY MS, LMHC, CDP, LCPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FURY
Provider First Name:
BETH
Provider Middle Name:
ANNE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, LMHC, CDP, LCPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SNYDER
Provider Other First Name:
BETH
Provider Other Middle Name:
ANNE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS, LMHC, CDP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1730403247
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/19/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
816 W FRANCIS AVE # 372
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPOKANE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99205-6512
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-294-7299
Provider Business Mailing Address Fax Number:
888-349-2185

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
422 W RIVERSIDE AVE STE 501
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-474-1976
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/26/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  LH60108630 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)