MEDICARE: LITA B. HICKEY LCSW

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	108998	TX
2	1041C0700X	Clinical Social Worker	LCSW-4726	HI

General Provider Information

NPI Number	:	1881352961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LITA B. HICKEY LCSW

Provider Business Mailing Address
First Line	:	500 ALA MOANA BLVD STE 7400
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813-4902
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 ALA MOANA BLVD STE 7400
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813-4902
Country	:	US
Telephone Number	:	561-567-8795
Fax Number	:

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

Provider Enumeration Date	:	12/06/2021
Last Update Date	:	06/22/2026

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