Provider Demographics
NPI:1952101289
Name:LICHAU, MELISSA SUE (LMHC)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:SUE
Last Name:LICHAU
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MISS
Other - First Name:MELISSA
Other - Middle Name:SUE
Other - Last Name:LAFLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6011 63RD AVENUE CT NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-7389
Mailing Address - Country:US
Mailing Address - Phone:253-320-3132
Mailing Address - Fax:
Practice Address - Street 1:6011 63RD AVENUE CT NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-7389
Practice Address - Country:US
Practice Address - Phone:253-320-3132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61603440101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health