Provider Demographics
NPI:1376653253
Name:RADICK, SHERI (MS,LMHC)
Entity Type:Individual
Prefix:MRS
First Name:SHERI
Middle Name:
Last Name:RADICK
Suffix:
Gender:F
Credentials:MS,LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19423 179TH CT NE
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98077-8206
Mailing Address - Country:US
Mailing Address - Phone:425-806-4975
Mailing Address - Fax:
Practice Address - Street 1:19423 179TH CT NE
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98077-8206
Practice Address - Country:US
Practice Address - Phone:425-806-4975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00006595101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health