Provider Demographics
NPI:1669036174
Name:RIVERWAY COUNSELING
Entity type:Organization
Organization Name:RIVERWAY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WICHMANN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW/LICSW
Authorized Official - Phone:360-838-3356
Mailing Address - Street 1:951 OFFICERS ROW
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-3849
Mailing Address - Country:US
Mailing Address - Phone:206-859-9805
Mailing Address - Fax:360-326-1877
Practice Address - Street 1:951 OFFICERS ROW
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-3849
Practice Address - Country:US
Practice Address - Phone:360-838-3356
Practice Address - Fax:360-326-1877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-30
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health