Provider Demographics
NPI:1225749880
Name:MCCLANNAHAN, CELESTE HELEN (LMFTA)
Entity Type:Individual
Prefix:MRS
First Name:CELESTE
Middle Name:HELEN
Last Name:MCCLANNAHAN
Suffix:
Gender:F
Credentials:LMFTA
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 585
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98238-0585
Mailing Address - Country:US
Mailing Address - Phone:801-309-1992
Mailing Address - Fax:
Practice Address - Street 1:28327 65TH DR NW
Practice Address - Street 2:
Practice Address - City:STANWOOD
Practice Address - State:WA
Practice Address - Zip Code:98292-8225
Practice Address - Country:US
Practice Address - Phone:801-309-1992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61367485106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist