Provider Demographics
NPI:1528385234
Name:SLOUBER, LYNNE M (LMHC, NCC, MED)
Entity Type:Individual
Prefix:MRS
First Name:LYNNE
Middle Name:M
Last Name:SLOUBER
Suffix:
Gender:F
Credentials:LMHC, NCC, MED
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 1072
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:WA
Mailing Address - Zip Code:98848-0400
Mailing Address - Country:US
Mailing Address - Phone:509-398-8618
Mailing Address - Fax:509-398-8618
Practice Address - Street 1:908 10TH AVE NW
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:WA
Practice Address - Zip Code:98801
Practice Address - Country:US
Practice Address - Phone:509-398-8618
Practice Address - Fax:509-398-8618
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00010673101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALH00010673OtherWASHINGTON DOH LICENSED MENTAL HEALTH