Provider Demographics
NPI:1699039784
Name:WEBB, STACIE JANE (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:STACIE
Middle Name:JANE
Last Name:WEBB
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9631 N. NEVADA ST.
Mailing Address - Street 2:SUITE 209
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218
Mailing Address - Country:US
Mailing Address - Phone:509-570-4098
Mailing Address - Fax:509-363-2762
Practice Address - Street 1:9631 N. NEVADA ST.
Practice Address - Street 2:SUITE 209
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218
Practice Address - Country:US
Practice Address - Phone:509-570-4098
Practice Address - Fax:509-363-2762
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW60276163104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker