Provider Demographics
NPI:1720247836
Name:STICE, CHRISTI JO (EDD, LPC, LISAC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTI
Middle Name:JO
Last Name:STICE
Suffix:
Gender:F
Credentials:EDD, LPC, LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 E HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-3597
Mailing Address - Country:US
Mailing Address - Phone:602-770-9430
Mailing Address - Fax:
Practice Address - Street 1:1901 N TREKELL RD
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-1770
Practice Address - Country:US
Practice Address - Phone:520-836-1029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-1359101YA0400X
AZLPC-11909101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)