MEDICARE: LAUREL M HICKS LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	34010038A	IN
2	1041C0700X	Clinical Social Worker	CSW.09924874	CO
3	1041C0700X	Clinical Social Worker	6801094277	MI

General Provider Information

NPI Number	:	1164895579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREL M HICKS LMSW

Provider Business Mailing Address
First Line	:	2934 S SHERMAN ST
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80113-1678
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2222 E TENNESSEE AVE STE 200
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80209-4637
Country	:	US
Telephone Number	:	--
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2015
Last Update Date	:	04/06/2026

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Directions to “ LAUREL M HICKS LMSW” Practice Location

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