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General NPI Number Information
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NPI Number | 1710264171
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Entity Type | Organization
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Legal Business Name | GENERATIONS COUNSELING
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Dates
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Enumeration Date | 11/12/2011
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Last Update Date | 10/09/2012
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Provider Practice Location Address
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Address Line | 2 SOUTH 56TH PLACE SUITE 201-C
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City | RIDGEFIELD
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State | WA
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Zip | 98642
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Country | US
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Telephone | 360-508-8743
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Fax | 360-887-0700
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Provider Business Mailing Address
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Address Line | PO BOX 1815
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City | WOODLAND
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State | WA
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Zip | 98674
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Country | US
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Telephone | 360-508-8743
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Fax | 360-887-0700
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Authorized Official
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Title or Position | OWNER / ADMINISTRATOR
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Name | MRS. SUSAN ANN GEBHARDT
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Credential | LMHC
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Telephone | 360-508-8743
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LH00011047
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License Number State | WA
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