Provider Demographics
NPI:1700529609
Name:ADELLE'S CHILD AND FAMILY SERVICES
Entity type:Organization
Organization Name:ADELLE'S CHILD AND FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ADELLE
Authorized Official - Middle Name:S
Authorized Official - Last Name:STUBBLEFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:360-747-7414
Mailing Address - Street 1:PO BOX 1329
Mailing Address - Street 2:
Mailing Address - City:ELMA
Mailing Address - State:WA
Mailing Address - Zip Code:98541-1329
Mailing Address - Country:US
Mailing Address - Phone:360-747-7414
Mailing Address - Fax:360-667-2666
Practice Address - Street 1:3 ROGER LN
Practice Address - Street 2:
Practice Address - City:ELMA
Practice Address - State:WA
Practice Address - Zip Code:98541-9504
Practice Address - Country:US
Practice Address - Phone:360-747-7414
Practice Address - Fax:360-667-2666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-18
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2146458Medicaid