Healthcare Provider Details

I. General information

NPI: 1861743361
Provider Name (Legal Business Name): AUNJULI A. HICKS LPC LIMITED LIABILITY COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2012
Last Update Date: 12/22/2023
Certification Date: 12/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 MILLBURN AVE STE 104
MILLBURN NJ
07041-1919
US

IV. Provider business mailing address

116 MILLBURN AVE STE 104
MILLBURN NJ
07041-1919
US

V. Phone/Fax

Practice location:
  • Phone: 908-364-7611
  • Fax: 908-913-0912
Mailing address:
  • Phone: 908-364-7611
  • Fax: 908-913-0912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37PC00408800
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00408800
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37AC00029500
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number506814
License Number StateNJ

VIII. Authorized Official

Name: DR. AUNJULI HICKS
Title or Position: OWNER/MANAGING DIRECTOR
Credential: PHD
Phone: 908-364-7611