Provider Demographics
NPI:1700131265
Name:STINCHFIELD, KATHLEEN (LPC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:STINCHFIELD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:WILDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 814
Mailing Address - Street 2:
Mailing Address - City:CONDON
Mailing Address - State:OR
Mailing Address - Zip Code:97823-0814
Mailing Address - Country:US
Mailing Address - Phone:503-302-8120
Mailing Address - Fax:
Practice Address - Street 1:1545 OSPREY DR
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-0040
Practice Address - Country:US
Practice Address - Phone:503-302-8120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ORC3623101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health