Provider Demographics
NPI:1265301949
Name:LANTZ, STEVIE L
Entity type:Individual
Prefix:MS
First Name:STEVIE
Middle Name:L
Last Name:LANTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11301 NE 7TH ST APT EE4
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-4984
Mailing Address - Country:US
Mailing Address - Phone:360-916-8936
Mailing Address - Fax:
Practice Address - Street 1:3205 NE 78TH ST STE 104
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-0697
Practice Address - Country:US
Practice Address - Phone:360-605-0713
Practice Address - Fax:360-845-2752
Is Sole Proprietor?:No
Enumeration Date:2025-11-01
Last Update Date:2025-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health