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Autumn Irvine, SUDP,CAAR
Counselor in Kelso, Washington
NPI 1871029140

Autumn Irvine is a Counselor based in Longview, WA. Autumn Irvine practices in Kelso, WA and has the professional credentials of SUDP,CAAR. The NPI Number for Autumn Irvine is 1871029140 and holds a License No. CP 60188084 (Washington).

The current practice location address for Autumn Irvine is 404 W Main St, Kelso, WA and can be reached out via phone at 360-423-2806 and via fax at 360-423-5128.

Location: 404 W Main St, Kelso, WA, 98632-5467
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1871029140
Provider Name
Autumn Irvine
Credential
SUDP,CAAR
Provider Entity Type
Individual
Gender
Female
Address
404 W Main St, Kelso, WA, 98632-5467
Phone Number
360-423-2806
Fax Number
360-423-5128
Provider Enumeration Date
05/05/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
404 W Main St
City
Kelso
State
Washington
Zip
98626-1118
Phone Number
360-423-2806
Fax Number
360-423-5128
person
Provider Business Mailing Address Details
Address
404 W Main St
City
Kelso
State
Washington
Zip
98626-1118
Phone Number
360-423-2806
Fax Number
360-423-5128
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
CG61313331 (Washington)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
CP 60188084 (Washington)
Definition
Definition to come...
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