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General NPI Number Information
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NPI Number | 1174184113
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Entity Type | Individual
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Provider Name | AMY JON CLICK MFT
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Gender | Female
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Dates
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Enumeration Date | 06/20/2019
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Last Update Date | 07/13/2023
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Provider Practice Location Address
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Address Line | 107 S MAIN ST STE D-204B
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City | COUPEVILLE
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State | WA
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Zip | 98239-3541
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Country | US
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Telephone | 206-829-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 107 S MAIN ST STE D-204B
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City | COUPEVILLE
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State | WA
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Zip | 98239-3541
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MG61123924
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LF61396016
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License Number State | WA
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