Healthcare Provider Details

I. General information

NPI: 1538091947
Provider Name (Legal Business Name): HOPE KICKLIGHTER THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2617 13TH ST NW APT A
WASHINGTON DC
20009-5359
US

IV. Provider business mailing address

2617 13TH ST NW APT A
WASHINGTON DC
20009-5359
US

V. Phone/Fax

Practice location:
  • Phone: 205-245-5187
  • Fax:
Mailing address:
  • Phone: 205-245-5187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: HOPE KICKLIGHTER
Title or Position: THERAPIST
Credential: LICSW
Phone: 205-245-5187