Healthcare Provider Details

I. General information

NPI: 1417360355
Provider Name (Legal Business Name): TIMOTHY RYAN HICKS MS, LPC, LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2014
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S JACKSON ST STE 250
DENVER CO
80209-3558
US

IV. Provider business mailing address

1100 JORIE BLVD STE 300 SUITE 300
OAK BROOK IL
60523-2219
US

V. Phone/Fax

Practice location:
  • Phone: 630-974-6602
  • Fax: 630-487-2411
Mailing address:
  • Phone: 630-974-6602
  • Fax: 630-487-2411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC0014901
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: