Provider Demographics
NPI:1508289950
Name:FICK, KYLEE (MSW)
Entity Type:Individual
Prefix:
First Name:KYLEE
Middle Name:
Last Name:FICK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 34TH ST
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-3353
Mailing Address - Country:US
Mailing Address - Phone:360-293-6973
Mailing Address - Fax:
Practice Address - Street 1:2601 M AVE
Practice Address - Street 2:SUITE C
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-3894
Practice Address - Country:US
Practice Address - Phone:360-293-6973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC603989941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical