Provider Demographics
NPI:1881746451
Name:GENEVIEVE, STEFFIE (MSW, LICSW, CDP, SAP)
Entity type:Individual
Prefix:
First Name:STEFFIE
Middle Name:
Last Name:GENEVIEVE
Suffix:
Gender:F
Credentials:MSW, LICSW, CDP, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 N SULLIVAN RD
Mailing Address - Street 2:STE F170
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99037-8543
Mailing Address - Country:US
Mailing Address - Phone:509-850-5991
Mailing Address - Fax:206-892-9709
Practice Address - Street 1:1005 N PINES RD
Practice Address - Street 2:SUITE 40
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4986
Practice Address - Country:US
Practice Address - Phone:509-850-5991
Practice Address - Fax:206-892-9709
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00003245101YA0400X
WALW00006488101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8898227OtherPTAN
WAG8898227OtherPTAN