Lissa A Wick, | |
884 W Park Ave, Port Townsend, WA 98368-2273 | |
(360) 385-0321 | |
(360) 379-5534 |
Full Name | Lissa A Wick |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 884 W Park Ave, Port Townsend, Washington |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1649850389 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Entity Name | Jefferson Community Counseling Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083701015 PECOS PAC ID: 6103715081 Enrollment ID: O20040311000167 |
Mailing Address | Practice Location Address |
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Lissa A Wick, Po Box 565, Port Townsend, WA 98368-0565 Ph: (360) 385-0321 | Lissa A Wick, 884 W Park Ave, Port Townsend, WA 98368-2273 Ph: (360) 385-0321 |
Jill M Paulk, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 884 West Park Avenue, Port Townsend, WA 98368 Phone: 360-385-0321 Fax: 360-379-5534 | |
Amy Lemay, MSW, LICSWA Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1243 Tremont St, Port Townsend, WA 98368 Phone: 818-915-4479 | |
Mary Fortman, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 915 Sheridan St Ste B103, Port Townsend, WA 98368 Phone: 360-385-4848 | |
Annemarie Mende, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 884 W Park Ave, Port Townsend, WA 98368 Phone: 360-385-0321 Fax: 360-385-3944 | |
Ms. Sara Smithson, LCSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 237 Taylor St Unit 2, Port Townsend, WA 98368 Phone: 360-436-6363 | |
Mrs. Anita Elaine Martina Abba Richard, LCMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1505 Hancock St, Lighthouse Co Center, Port Townsend, WA 98368 Phone: 360-379-8779 Fax: 360-379-2411 | |
Mrs. Donette Boyett, LCSW-A Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 884 W Park Ave, Port Townsend, WA 98368 Phone: 360-385-0321 Fax: 360-385-3944 |