Provider Demographics
NPI:1083775274
Name:STUBBLEFIELD, EILEEN KATHRYN (LMHC)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:KATHRYN
Last Name:STUBBLEFIELD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6919 97TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498-3411
Mailing Address - Country:US
Mailing Address - Phone:253-584-1760
Mailing Address - Fax:
Practice Address - Street 1:OF PSYCHIATRY
Practice Address - Street 2:MADIGAN ARMY MEDICAL CENTER
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-0001
Practice Address - Country:US
Practice Address - Phone:253-968-2770
Practice Address - Fax:253-968-2765
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005808101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health