Provider Demographics
NPI:1790361475
Name:STIKA, ALYSSA MICHELLE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:MICHELLE
Last Name:STIKA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 NC HIGHWAY 561 W
Mailing Address - Street 2:
Mailing Address - City:AHOSKIE
Mailing Address - State:NC
Mailing Address - Zip Code:27910-9742
Mailing Address - Country:US
Mailing Address - Phone:252-377-7773
Mailing Address - Fax:
Practice Address - Street 1:495 CAROLINA RD
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-5856
Practice Address - Country:US
Practice Address - Phone:252-377-7773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701010048101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional