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General NPI Number Information
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NPI Number | 1790361475
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Entity Type | Individual
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Provider Name | ALYSSA MICHELLE STIKA LPC
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Gender | Female
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Dates
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Enumeration Date | 03/22/2021
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Last Update Date | 03/22/2021
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Provider Practice Location Address
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Address Line | 495 CAROLINA RD
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City | SUFFOLK
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State | VA
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Zip | 23434-5856
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Country | US
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Telephone | 252-377-7773
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Fax |
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Provider Business Mailing Address
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Address Line | 233 NC HIGHWAY 561 W
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City | AHOSKIE
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State | NC
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Zip | 27910-9742
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Country | US
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Telephone | 252-377-7773
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701010048
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License Number State | VA
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