Provider Demographics
NPI:1013628114
Name:BILLINGSLEA, KATIE SUZANNE (MSW, LICSWA)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:SUZANNE
Last Name:BILLINGSLEA
Suffix:
Gender:F
Credentials:MSW, LICSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7140 289TH PL NW
Mailing Address - Street 2:
Mailing Address - City:STANWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98292-8408
Mailing Address - Country:US
Mailing Address - Phone:360-670-9304
Mailing Address - Fax:
Practice Address - Street 1:7140 289TH PL NW
Practice Address - Street 2:
Practice Address - City:STANWOOD
Practice Address - State:WA
Practice Address - Zip Code:98292-8408
Practice Address - Country:US
Practice Address - Phone:360-670-9304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC613826521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical