MARY L HAGSTROM CDP
NPI 1538238191
Counselor - Addiction (Substance Use Disorder) in Colville, WA
Active since November 07, 2006
About Mary L Hagstrom Cdp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY L HAGSTROM CDP (NPI 1538238191) is an individual addiction (substance use disorder) provider in Colville, Washington, licensed in Washington (CP00001268) and active in the NPI registry since November 2006.
NPPES Registry Identity
NPI1538238191
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameMARY L HAGSTROMCredential: CDP
Location Address165 E HAWTHORNE AVEColville, WA 99114-2629
Mailing Address613 W Main AveChewelah, WA 99109-9146 · (509) 935-0866
Phone(509) 684-4597
Sole ProprietorNo
Enumeration DateNovember 7, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1538238191 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 · CP00001268
165 E HAWTHORNE AVE, Colville, WA 99114
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Counselor (Addiction (Substance Use Disorder))
165 E HAWTHORNE AVE
COLVILLE, WA 99114
COLVILLE, WA 99114
Counselor (Addiction (Substance Use Disorder))
165 E HAWTHORNE AVE
COLVILLE, WA 99114
COLVILLE, WA 99114
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1538238191, enumerated as an "individual" on November 07, 2006.
The provider is located at 165 E HAWTHORNE AVE COLVILLE, WA 99114 and the phone number is (509) 684-4597.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
