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General NPI Number Information
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NPI Number | 1528631652
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Entity Type | Organization
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Legal Business Name | KALEIDOSCOPE ART THERAPY AND COUNSELING
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Dates
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Enumeration Date | 07/16/2021
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Last Update Date | 07/16/2021
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Provider Practice Location Address
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Address Line | 9951 MICKELBERRY RD NW STE 215
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City | SILVERDALE
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State | WA
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Zip | 98383-8309
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Country | US
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Telephone | 360-900-1319
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Fax |
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Provider Business Mailing Address
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Address Line | 9951 MICKELBERRY RD NW STE 215
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City | SILVERDALE
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State | WA
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Zip | 98383-8309
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Country | US
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Telephone | 360-900-1319
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | STEPHANIE LEFTWICH-NEEDHAM
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Credential | LMHC
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Telephone | 757-754-1158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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