Provider Demographics
NPI:1861599292
Name:KHALSA, SIRI SIMRAN KAUR (LPC, LPCC)
Entity type:Individual
Prefix:MS
First Name:SIRI SIMRAN
Middle Name:KAUR
Last Name:KHALSA
Suffix:
Gender:F
Credentials:LPC, LPCC
Other - Prefix:MS
Other - First Name:LILLA
Other - Middle Name:SSK
Other - Last Name:KHALSA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC, LPCC
Mailing Address - Street 1:122 E 28TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98663-3015
Mailing Address - Country:US
Mailing Address - Phone:828-777-1962
Mailing Address - Fax:
Practice Address - Street 1:122 E 28TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-3015
Practice Address - Country:US
Practice Address - Phone:828-777-1962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7752101YM0800X
NM0128361101YM0800X
ORC8675101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health