Provider Demographics
NPI:1225499122
Name:STEEN, GRETCHEN (CADC)
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:
Last Name:STEEN
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1945
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-0905
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1009 HIGHWAY 2
Practice Address - Street 2:SUITE E
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-2712
Practice Address - Country:US
Practice Address - Phone:208-255-9333
Practice Address - Fax:208-263-6364
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-19
Last Update Date:2016-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID112006101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)