Provider Demographics
NPI:1639059488
Name:SQUIBB, CHELEENA LYNN (BA, AAC)
Entity type:Individual
Prefix:
First Name:CHELEENA
Middle Name:LYNN
Last Name:SQUIBB
Suffix:
Gender:F
Credentials:BA, AAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 COMMERCE AVE
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-3096
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:360-423-5128
Practice Address - Street 1:1302 COMMERCE AVE
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-3096
Practice Address - Country:US
Practice Address - Phone:360-423-2806
Practice Address - Fax:360-423-5128
Is Sole Proprietor?:No
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health