Individual
ELISE M STAAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, LMHC
Contact information
Practice address
827 6TH ST, CLARKSTON, WA 99403-2002
(208) 717-2288
(208) 980-7055
Mailing address
2654 27TH ST, CLARKSTON, WA 99403-1698
(509) 295-1861
(208) 980-7055
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LCPC-8108
ID
101YM0800X
Mental Health Counselor
LPC-7627
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCPC-8108
LCPC
ID
01
—
LH61120561
LMHC
WA
Enumeration date
03/12/2020
Last updated
05/18/2021
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