Provider Demographics
NPI:1104215714
Name:FLICK, AUTUMN (PHD, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:AUTUMN
Middle Name:
Last Name:FLICK
Suffix:
Gender:F
Credentials:PHD, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6015 WEBSTER WAY
Mailing Address - Street 2:
Mailing Address - City:CASHMERE
Mailing Address - State:WA
Mailing Address - Zip Code:98815-9521
Mailing Address - Country:US
Mailing Address - Phone:206-227-0619
Mailing Address - Fax:
Practice Address - Street 1:6015 WEBSTER WAY
Practice Address - Street 2:
Practice Address - City:CASHMERE
Practice Address - State:WA
Practice Address - Zip Code:98815-9521
Practice Address - Country:US
Practice Address - Phone:206-227-0619
Practice Address - Fax:206-227-0619
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-20
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1-14-17808103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst