Provider Demographics
NPI:1518420579
Name:STULLICK, SUMMER LYNN (MS, MHP, LMHCA)
Entity Type:Individual
Prefix:
First Name:SUMMER
Middle Name:LYNN
Last Name:STULLICK
Suffix:
Gender:F
Credentials:MS, MHP, LMHCA
Other - Prefix:
Other - First Name:SUMMER
Other - Middle Name:LYNN
Other - Last Name:DOLL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BA
Mailing Address - Street 1:1016 ARLEO LN
Mailing Address - Street 2:
Mailing Address - City:FIRCREST
Mailing Address - State:WA
Mailing Address - Zip Code:98466-6528
Mailing Address - Country:US
Mailing Address - Phone:253-205-9448
Mailing Address - Fax:
Practice Address - Street 1:1016 ARLEO LN
Practice Address - Street 2:
Practice Address - City:FIRCREST
Practice Address - State:WA
Practice Address - Zip Code:98466-6528
Practice Address - Country:US
Practice Address - Phone:253-205-9448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-08
Last Update Date:2022-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YM0800X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselor