Provider Demographics
NPI:1609153592
Name:BRECKENRIDGE, RHONDA LEEANN (LICSW)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:LEEANN
Last Name:BRECKENRIDGE
Suffix:
Gender:
Credentials:LICSW
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:LEEANN
Other - Last Name:BARSTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:600 ORONDO AVE
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2800
Mailing Address - Country:US
Mailing Address - Phone:509-662-6000
Mailing Address - Fax:
Practice Address - Street 1:980 EASTMONT AVE
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-6602
Practice Address - Country:US
Practice Address - Phone:509-662-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-07
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW602435171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1090983Medicaid