Provider Demographics
NPI:1184647554
Name:KUEHLEM, PATRICIA ANN (LCPC, LMHC,CAP,CRADC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANN
Last Name:KUEHLEM
Suffix:
Gender:F
Credentials:LCPC, LMHC,CAP,CRADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4304 NE 158TH PL
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-7191
Mailing Address - Country:US
Mailing Address - Phone:360-696-4061
Mailing Address - Fax:360-737-1419
Practice Address - Street 1:1601 EAST 4TH PLAIN BOULEVARD
Practice Address - Street 2:DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER V3-SATP
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661
Practice Address - Country:US
Practice Address - Phone:360-696-4061
Practice Address - Fax:360-737-1419
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-005450101YP2500X
WA60206734101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional