Provider Demographics
NPI:1366284168
Name:STICKELMEYER, CARA MARIE (CBT)
Entity type:Individual
Prefix:MRS
First Name:CARA
Middle Name:MARIE
Last Name:STICKELMEYER
Suffix:
Gender:F
Credentials:CBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-2225
Mailing Address - Country:US
Mailing Address - Phone:509-835-4404
Mailing Address - Fax:509-835-4400
Practice Address - Street 1:801 E 2ND AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-2225
Practice Address - Country:US
Practice Address - Phone:509-835-4404
Practice Address - Fax:509-835-4400
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty