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General NPI Number Information
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NPI Number | 1144701293
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Entity Type | Organization
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Legal Business Name | STEEP STREET COUNSELING, LLC
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Dates
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Enumeration Date | 08/27/2018
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Last Update Date | 08/27/2018
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Provider Practice Location Address
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Address Line | 601 E MCLOUGHLIN BLVD
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City | VANCOUVER
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State | WA
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Zip | 98663-3358
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Country | US
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Telephone | 360-607-6017
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Fax |
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Provider Business Mailing Address
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Address Line | 601 E MCLOUGHLIN BLVD
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City | VANCOUVER
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State | WA
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Zip | 98663-3358
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Country | US
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Telephone | 360-607-6017
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SANDY RUBY SEWELL
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Credential | LICSW, CMHS
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Telephone | 360-607-6017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | LW60271794
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | LW60271794
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License Number State | WA
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