Elise M Staab, LCPC, LMHC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LCPC-8108 Issued in ID

Practice address

827 6TH St
Clarkston, WA 99403-2002

Phone

(208) 717-2288

Fax

(208) 980-7055

NPI assigned

Mar 12, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Phoenix Counseling

  • Mental Health Counselor
  • Clarkston, WA
  • NPI 1235895178
  NPD Authorized official
• Dragonfly Counseling PLLC

  • Clinical Social Worker
  • Clarkston, WA
  • NPI 1730607854

  Mental Health

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1689200453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2654 27TH ST",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994031698",
            "telephone_number": "509-295-1861",
            "fax_number": "208-980-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 6TH ST",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994032002",
            "telephone_number": "208-717-2288",
            "fax_number": "208-980-7055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 Bridge St Ste C",
            "address_purpose": "LOCATION",
            "city": "Clarkston",
            "state": "WA",
            "postal_code": "994032921",
            "country_code": "US",
            "telephone_number": "509-254-5053 x9",
            "fax_number": "509-769-3500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Main St Ste 204",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "ID",
            "postal_code": "835011819",
            "country_code": "US",
            "telephone_number": "208-717-2288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAAB",
        "first_name": "ELISE",
        "middle_name": "M",
        "credential": "LCPC, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-12",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC-7627",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ID",
            "license": "LCPC-8108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMHC",
            "identifier": "LH61120561",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCPC",
            "identifier": "LCPC-8108",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "estaab@phoenixcounselingid.com",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "301 Main St Ste 204",
            "city": "Lewiston",
            "state": "ID",
            "country_code": "US",
            "postal_code": "835011819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michelle Lynn Skinner, RD CD
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• Snake River Adult Medicine LLC
• David Sperry, LMHC
• Melissa Squires-Williams, LMC
• Stat Med Solutions PC Inc
• Alexis Amanda Marie Stegner
• Sundae Elaine Stone, MSW
• David E Storey, R.PH.
• Teresa Storey

• Counselor in Clarkston, WA
• Providers in Clarkston, WA by specialty
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.