Healthcare Provider Details

I. General information

NPI: 1174815401
Provider Name (Legal Business Name): ANITA FAYE SNODGRASS GUSHURST M.A., LMHC, CDPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2011
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1607 OFFICERS ROW
VANCOUVER WA
98661-3862
US

IV. Provider business mailing address

101 E 8TH ST STE 110
VANCOUVER WA
98660-3294
US

V. Phone/Fax

Practice location:
  • Phone: 360-524-2214
  • Fax: 360-524-2214
Mailing address:
  • Phone: 360-524-2214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberCO60246524
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLH60382513
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60382513
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number60382513
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: