Healthcare Provider Details

I. General information

NPI: 1629981774
Provider Name (Legal Business Name): CATHERINE ELIZABETH HICKMAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 NORTHWEST BLVD STE 200-2
GRANDVIEW OH
43212-3856
US

IV. Provider business mailing address

1858 BRANDIGEN LN
COLUMBUS OH
43228-3883
US

V. Phone/Fax

Practice location:
  • Phone: 614-783-6010
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.2608585
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: