Provider Demographics
NPI:1215429873
Name:VANVALKENBURGH LOHMAN, STEPHANIE CHRISTINE (LICSW)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:CHRISTINE
Last Name:VANVALKENBURGH LOHMAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13401 NE BEL RED RD STE B12
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2322
Mailing Address - Country:US
Mailing Address - Phone:206-350-7506
Mailing Address - Fax:
Practice Address - Street 1:12900 NE 180TH ST STE 160
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-5778
Practice Address - Country:US
Practice Address - Phone:206-350-7506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW612135861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical