Active NPI
Jessica Lynn Stickley, MS, MHP
- Mental Health Counselor
- Longview, WA
National Provider Identifier
1508098930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CG60158326
- Practice address
- 1615 Delaware St
Longview, WA 98632-2367 - Phone
- (360) 414-7525
- NPI assigned
- Aug 18, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CO60149118 | WA | |
| Professional Counselor | 101YP2500X | RC60089841 | WA | |
| Mental Health Counselor | 101YM0800X | CG60158326 | WA | Primary |
Addresses
Primary practice location
1615 Delaware St
Longview, WA 98632-2367
Mailing address
PO Box 579
Centralia, WA 98531-0579
Phone (366) 669-6009
Other practice location 1
135 W Main St
Cascade Mental Health Care
Chehalis, WA 98532-4817
Phone (360) 748-6696 ext. 2261
Other practice location 2
1641 Kresky Ave
Centralia, WA 98531
Phone (360) 261-6930
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CO60149118 | WA | MD | Addiction (Substance Use Disorder) Counselor |
| CG60158326 | WA | MD | Mental Health Counselor |
| RC60089841 | WA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696204800000",
"number": "1508098930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 579",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "985310579",
"telephone_number": "366-669-6009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1615 DELAWARE ST",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986322367",
"telephone_number": "360-414-7525"
}
],
"practiceLocations": [
{
"address_1": "135 W Main St",
"address_2": "Cascade Mental Health Care",
"address_purpose": "LOCATION",
"city": "Chehalis",
"state": "WA",
"postal_code": "985324817",
"country_code": "US",
"telephone_number": "360-748-6696 x2261",
"fax_number": "360-748-0627",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1641 Kresky Ave",
"address_purpose": "LOCATION",
"city": "Centralia",
"state": "WA",
"postal_code": "98531",
"country_code": "US",
"telephone_number": "360-261-6930",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STICKLEY",
"first_name": "JESSICA",
"middle_name": "LYNN",
"credential": "MS, MHP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-18",
"last_updated": "2023-10-02",
"certification_date": "2023-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "CO60149118",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WA",
"license": "RC60089841",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "CG60158326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longview, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.