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MICHELLE BUCKHOLZ SUDP
NPI 1215323977
Counselor - Addiction (Substance Use Disorder) in Kelso, WA

Active since April 09, 2015

NPPES record last updated: October 23, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 23, 2023, Jul 25, 2022, Feb 8, 2016 (3 updates tracked since 2016).

About Michelle Buckholz Sudp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHELLE BUCKHOLZ SUDP (NPI 1215323977) is an individual addiction (substance use disorder) provider in Kelso, Washington, licensed in Washington (CP60551022) and active in the NPI registry since April 2015.

NPPES Registry Identity

NPI1215323977
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameMICHELLE BUCKHOLZCredential: SUDP
Location Address621 GRADE STKelso, WA 98626-2606
Mailing Address1057 12th AveLongview, WA 98632-2509 · (360) 425-9210
Phone(360) 425-9210
Sole ProprietorNo
Enumeration DateApril 9, 2015
Last NPPES UpdateOctober 23, 20233 updates tracked since enumeration
NPPES CertifiedOctober 23, 2023
✔ NPI 1215323977 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in WA · CP60551022
621 GRADE ST, Kelso, WA 98626
Open in Google Maps ↗

Other Identifiers 1

Medicaid2088085WA

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DEBORAH SMITH
Counselor (Addiction (Substance Use Disorder))
621 GRADE ST
KELSO, WA 98626
Cowlitz County (360) 425-5855
COWLITZ FAMILY HEALTH CENTER
Clinic/Center (Rehabilitation, Substance Use Disorder)
621 GRADE ST
KELSO, WA 98626
Cowlitz County (360) 636-3892
RAMA MITCHELL JR. SUDP
Counselor (Addiction (Substance Use Disorder))
621 GRADE ST
KELSO, WA 98626
Cowlitz County (360) 425-9210
GREGORY ERNEST ERBES SUDP
Counselor (Addiction (Substance Use Disorder))
621 GRADE ST
KELSO, WA 98626
Cowlitz County (360) 425-9210

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michelle Buckholz's NPI number?

The NPI number for Michelle Buckholz is 1215323977. It was assigned to this individual provider in the NPPES registry on April 9, 2015.

Where is Michelle Buckholz located?

Michelle Buckholz practices at 621 Grade St, Kelso, WA 98626. The listed phone number is (360) 425-9210.

What is Michelle Buckholz's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Michelle Buckholz was last updated on October 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.