Provider Demographics
NPI:1710264171
Name:GENERATIONS COUNSELING
Entity Type:Organization
Organization Name:GENERATIONS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GEBHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:360-508-8743
Mailing Address - Street 1:PO BOX 1815
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98674
Mailing Address - Country:US
Mailing Address - Phone:360-508-8743
Mailing Address - Fax:360-887-0700
Practice Address - Street 1:2 SOUTH 56TH PLACE
Practice Address - Street 2:SUITE 201-C
Practice Address - City:RIDGEFIELD
Practice Address - State:WA
Practice Address - Zip Code:98642
Practice Address - Country:US
Practice Address - Phone:360-508-8743
Practice Address - Fax:360-887-0700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-12
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00011047251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health