Healthcare Provider Details

I. General information

NPI: 1144701293
Provider Name (Legal Business Name): STEEP STREET COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2018
Last Update Date: 08/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E MCLOUGHLIN BLVD
VANCOUVER WA
98663-3358
US

IV. Provider business mailing address

601 E MCLOUGHLIN BLVD
VANCOUVER WA
98663-3358
US

V. Phone/Fax

Practice location:
  • Phone: 360-607-6017
  • Fax:
Mailing address:
  • Phone: 360-607-6017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberLW60271794
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberLW60271794
License Number StateWA

VIII. Authorized Official

Name: MRS. SANDY RUBY SEWELL
Title or Position: OWNER
Credential: LICSW, CMHS
Phone: 360-607-6017