JACQUELINE LICEA (NPI# 1831738160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831738160 |
| Entity Type | Individual |
| Full Name | JACQUELINE LICEA |
| Practice Address |
3430 Sw 320th St Ste D2 Federal Way WA 98023-2292 |
| Practice Telephone | 2532896099 |
| Mailing Telephone | 2532896099 |
| Enumeration Date | 2020-01-03 |
| Last Update Date | 2020-01-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
3430 SW 320TH ST STE D2 |
| City | FEDERAL WAY |
| State | WA |
| Zip Code | 98023-2292 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659515013 | Laura Beth Wallace | Marriage & Family Therapist | 3430 Sw 320th St Ste D2, Federal Way, WA 98023-2292 | 2009-04-28 |
| 1649893199 | Sinead Byrne | Marriage & Family Therapist | 3430 Sw 320th St Ste D2, Federal Way, WA 98023-2292 | 2020-05-19 |
| 1528620010 | Cherie V Mckale | Counselor | 3430 Sw 320th St Ste D2, Federal Way, WA 98023-2292 | 2019-07-03 |
| 1790347466 | Erin E Dierickx | Marriage & Family Therapist | 3430 Sw 320th St Ste D2, Federal Way, WA 98023-2292 | 2019-07-02 |
| 1083279327 | Shauna Gauthier | Counselor | 3430 Sw 320th St Ste D2, Federal Way, WA 98023-2292 | 2019-05-02 |
| 1629535554 | Ananda Duprey Leininger | Counselor | 3430 Sw 320th St Ste D2, Federal Way, WA 98023-2292 | 2019-02-27 |
| 1902325541 | Karin R Riggs | Nurse Practitioner | 3430 Sw 320th St Ste D2, Federal Way, WA 98023-2292 | 2017-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366093908 | Marlene Dawson | Technician | 33228 37th Place S.w., Federal Way, WA 98023 | 2019-09-25 |
| 1861994956 | Allen Abelgas Schimke | Registered Nurse | 1300 Sw Campus Drive Unit 38-4, Federal Way, WA 98023 | 2018-03-05 |
| 1568981298 | Hau Thi-le Vu | Dental Hygienist | 31174 2nd Pl Sw, Federal Way, WA 98023 | 2017-09-13 |
| 1700309416 | Jennifer Lynn Cha | Physician Assistant | 820 Sw 341st St., Federal Way, WA 98023 | 2017-07-25 |
| 1205373958 | Irina Poiata | Reflexologist | 1900 Sw Campus De Apt 15- 303, Federal Way, WA 98023 | 2017-01-19 |
| 1194275800 | Cynthia Marcellus | Counselor | 4523 Federal Ave, Everett, WA 98023 | 2016-10-05 |
| 1023441383 | Samantha Anne Larson | Pharmacist | 1300 Sw Campus Drive Apt 4-4, Federal Way, WA 98023 | 2013-08-09 |
| 1609149079 | Stacey Lee Beilke | Massage Therapist | 215 Sw 319th Lane, Apt L204, Federal Way, WA 98023 | 2012-02-16 |
| 1336456110 | Elweda Silva | General Acute Care Hospital | 31054 1st Pl Sw, Federal Way, WA 98023 | 2010-09-01 |
| 1114168739 | Aleksandra Starikov | Mechanotherapist | 34425 16th Ave Sw, Federal Way, WA 98023 | 2009-03-11 |
| Find all providers in zip 98023 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538708540 | Chisom Chiedu-okoara | Counselor | 33405 8th Ave S Unit 200, Federal Way, WA 98003-6639 | 2019-12-23 |
| 1831665488 | Spectrum Psychological Services | Counselor | 33305 1st Way S Ste B212, Federal Way, WA 98003-6259 | 2018-10-22 |
| 1255806188 | Gail Warner | Counselor | 33505 13th Pl S Ste C, Federal Way, WA 98003-6337 | 2018-10-08 |
| 1497255863 | Marinah Bentley | Counselor | 35703 16th Ave S Apt H102, Federal Way, WA 98003-7387 | 2018-02-12 |
| 1174984124 | Linh Wampler | Counselor | 815 Sw 355th Ct, Federal Way, WA 98023-8130 | 2016-03-17 |
| 1649642042 | Susana Beatriz Puricelli | Counselor | 30209 21st Ave S, Federal Way, WA 98003-4249 | 2015-10-24 |
| 1841547403 | Jessica A Scales | Counselor | 202 S 348th St Ste 2, Federal Way, WA 98003 | 2012-08-13 |
| 1215230867 | Amelia M.j. Carroll | Counselor | 402 S 333rd St Ste 133, Federal Way, WA 98003-6073 | 2010-12-20 |
| 1053570739 | Michael Todd Grove | Counselor | 31719 50th Ter Sw, #r202, Federal Way, WA 98023-3764 | 2008-06-06 |
| 1952585820 | Leila C Faber | Counselor | 2902 Sw Dash Point Rd, Federal Way, WA 98023-2348 | 2007-12-27 |
| Find all providers in FEDERAL WAY | ||||
| City | FEDERAL WAY |
| Zip Code | 98023 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.