person
Vivian Hicks, MA
Mental Health Counselor in Jamestown, Kentucky
NPI 1053712711

Vivian Hicks is a Mental Health Counselor based in Jamestown, KY and is specialized in Mental Health. Vivian Hicks practices in Jamestown, KY and has the professional credentials of MA. The NPI Number for Vivian Hicks is 1053712711 and holds a License No. CO 60457984 (Kentucky).

The current practice location address for Vivian Hicks is 79 Lilly Creek Ln, Jamestown, KY and can be reached out via phone at 253-625-0141 and via fax at 253-302-5406.

Location: 79 Lilly Creek Ln, Jamestown, KY, 42629-7924
person
Provider Profile Details
NPI Number
1053712711
Provider Name
Vivian Hicks
Credential
MA
Provider Entity Type
Individual
Gender
Female
Address
79 Lilly Creek Ln, Jamestown, KY, 42629-7924
Phone Number
253-625-0141
Fax Number
253-302-5406
Provider Enumeration Date
09/11/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
MC60587450 01 WA WASHINGTON STATE LMHCA
LH60776174 01 WA MENTAL HEALTH COUNSELOR LICENSE
4397 01 AL ALABAMA STATE LICENSE
CO 60457984 01 WA WASHINGTON STATE CDPT
275012 01 KY KENTUCKY LPCC LICENSE
institution
Provider Business Practice Location Address Details
Address
79 Lilly Creek Ln
City
State
Zip
42629-7924
Phone Number
253-625-0141
Fax Number
253-302-5406
person
Provider Business Mailing Address Details
Address
79 Lilly Creek Ln
City
State
Zip
42629-7924
Phone Number
253-625-0141
Fax Number
253-302-5406
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
275012 (Kentucky)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
CO 60457984 (Washington)
Definition
Definition to come...
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