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NPI Code Detail

MEDICARE: MICHELE HICKEY LPC

MEDICARE:   MICHELE  HICKEY  LPC
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
1101YP2500XProfessional CounselorC.2103838OH

General Provider Information

NPI Number : 1366178824
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE HICKEY LPC
Provider Business Mailing Address
First Line : 7652 KATY DR
Second Line :
City : DAYTON
State : OH
Zip : 45459-3619
Country : US
Telephone Number : 937-371-1381
Fax Number :
Provider Business Practice Location Address
First Line : 761 MIAMISBURG CENTERVILLE RD
Second Line :
City : WASHINGTON TOWNSHIP
State : OH
Zip : 45459-6501
Country : US
Telephone Number : 937-319-4448
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2022
Last Update Date : 07/27/2022

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