Healthcare Provider Details

I. General information

NPI: 1437711371
Provider Name (Legal Business Name): STACIE NP TOWNSEND LMHCA, LMFTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: STACIE NP JENKINS

II. Dates (important events)

Enumeration Date: 07/01/2019
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1498 SE TECH CENTER PL STE 300
VANCOUVER WA
98683-5509
US

IV. Provider business mailing address

11005 NE 88TH AVE
VANCOUVER WA
98662-1486
US

V. Phone/Fax

Practice location:
  • Phone: 360-619-2226
  • Fax: 360-326-9691
Mailing address:
  • Phone: 360-903-4565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMG61599074
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61599086
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: