Healthcare Provider Details

I. General information

NPI: 1306300439
Provider Name (Legal Business Name): KATHRYN MAY STEFANO MA, LMHCA, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHRYN MAY CONDON

II. Dates (important events)

Enumeration Date: 01/23/2019
Last Update Date: 09/14/2020
Certification Date: 09/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 W 7TH AVE STE 160B
SPOKANE WA
99204-2832
US

IV. Provider business mailing address

707 W 7TH AVE STE 160B
SPOKANE WA
99204-2832
US

V. Phone/Fax

Practice location:
  • Phone: 509-262-5447
  • Fax: 509-473-4840
Mailing address:
  • Phone: 509-262-5447
  • Fax: 509-473-4840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61069542
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: