Provider Demographics
NPI:1366796922
Name:VANPELT, LARENA FRANCINE
Entity type:Individual
Prefix:
First Name:LARENA
Middle Name:FRANCINE
Last Name:VANPELT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LARENA
Other - Middle Name:FRANCINE
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 573
Mailing Address - Street 2:
Mailing Address - City:WHITE SWAN
Mailing Address - State:WA
Mailing Address - Zip Code:98952-0573
Mailing Address - Country:US
Mailing Address - Phone:509-865-5121
Mailing Address - Fax:509-984-3793
Practice Address - Street 1:511 S ELM ST
Practice Address - Street 2:
Practice Address - City:TOPPENISH
Practice Address - State:WA
Practice Address - Zip Code:98948-1651
Practice Address - Country:US
Practice Address - Phone:509-865-5121
Practice Address - Fax:509-984-3793
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-05
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACO 60181087Other101YA0400X - COUNSELOR - ADDICTION (SUBSTANCE USE DISORDER)