Healthcare Provider Details

I. General information

NPI: 1730015124
Provider Name (Legal Business Name): MEIA LEA GLICK LMHC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOHNATHAN MEIA GLICK LMHC-A

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N 36TH ST STE 426
SEATTLE WA
98103-8827
US

IV. Provider business mailing address

500 28TH AVE S
SEATTLE WA
98144-2420
US

V. Phone/Fax

Practice location:
  • Phone: 601-689-4892
  • Fax:
Mailing address:
  • Phone: 425-591-1247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHCA.MC.70072628
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: