Provider Demographics
NPI:1902182405
Name:PENNEY, STEVEN DEAN (CDP)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:DEAN
Last Name:PENNEY
Suffix:
Gender:M
Credentials:CDP
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 508
Mailing Address - Street 2:
Mailing Address - City:OAKVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98568-0508
Mailing Address - Country:US
Mailing Address - Phone:360-709-1733
Mailing Address - Fax:360-273-8957
Practice Address - Street 1:420 HOWANUT RD.
Practice Address - Street 2:
Practice Address - City:OAKVILLE
Practice Address - State:WA
Practice Address - Zip Code:98568-0508
Practice Address - Country:US
Practice Address - Phone:360-709-1733
Practice Address - Fax:360-273-8957
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
WACP00001889101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor