Provider Demographics
NPI:1609028471
Name:STERN, KYLIE ANN (MA, LMHC, LMFTA,CDPT)
Entity type:Individual
Prefix:MS
First Name:KYLIE
Middle Name:ANN
Last Name:STERN
Suffix:
Gender:F
Credentials:MA, LMHC, LMFTA,CDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 E OLIVE ST
Mailing Address - Street 2:SOUND MENTAL HEALTH
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2735
Mailing Address - Country:US
Mailing Address - Phone:206-302-2200
Mailing Address - Fax:206-302-2210
Practice Address - Street 1:4240 AUBURN WAY N
Practice Address - Street 2:SOUND MENTAL HEALTH
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-1311
Practice Address - Country:US
Practice Address - Phone:253-876-8900
Practice Address - Fax:253-876-8910
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG60128136106H00000X
WALH60218786101YM0800X
WACO60114998101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor