Provider Demographics
NPI:1619668670
Name:SCHICK, JONATHAN SHEEHAN (A-MFT)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:SHEEHAN
Last Name:SCHICK
Suffix:
Gender:M
Credentials:A-MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5915 MUIRWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-1880
Mailing Address - Country:US
Mailing Address - Phone:907-317-7505
Mailing Address - Fax:
Practice Address - Street 1:5915 MUIRWOOD DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502-1880
Practice Address - Country:US
Practice Address - Phone:907-317-7505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK209015101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health