Individual
STEPHANIE DIANNE BAXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
831 12TH AVE, LONGVIEW, WA 98632-2403
(360) 998-2349
(360) 998-2887
Mailing address
1057 12TH AVE, LONGVIEW, WA 98632-2509
(360) 636-3892
(360) 232-8400
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LW60990251
WA
104100000X
Social Worker
Primary
LW60990251
WA
1041C0700X
Clinical Social Worker
LW60990251
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2146977
—
WA
Enumeration date
04/23/2019
Last updated
04/02/2026
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