Provider Demographics
NPI:1629353040
Name:HANSEN-DEL RIO, STEPHENIE K (LMHC)
Entity Type:Individual
Prefix:
First Name:STEPHENIE
Middle Name:K
Last Name:HANSEN-DEL RIO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:STEPHENIE
Other - Middle Name:K
Other - Last Name:HANSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC-A
Mailing Address - Street 1:1412 SW 43RD ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-4803
Mailing Address - Country:US
Mailing Address - Phone:206-229-5025
Mailing Address - Fax:
Practice Address - Street 1:1412 SW 43RD ST STE 240
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-4803
Practice Address - Country:US
Practice Address - Phone:206-226-0862
Practice Address - Fax:425-272-2717
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60476181101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health