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General NPI Number Information
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NPI Number | 1740834985
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Entity Type | Individual
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Provider Name | MATTHEW ARTHUR JUDE STICHMEN MA, LMHC
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Gender | Male
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Dates
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Enumeration Date | 07/25/2019
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Last Update Date | 07/25/2019
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Provider Practice Location Address
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Address Line | 4033 E MADISON ST STE 107
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City | SEATTLE
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State | WA
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Zip | 98112-3104
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Country | US
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Telephone | 206-701-5588
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Fax |
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Provider Business Mailing Address
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Address Line | 16032 30TH AVE NE
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City | LAKE FOREST PARK
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State | WA
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Zip | 98155-6502
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Country | US
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Telephone | 206-693-8469
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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 | LH60797328
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License Number State | WA
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