Healthcare Provider Details

I. General information

NPI: 1073439923
Provider Name (Legal Business Name): RESILIENT HUMANS PSYCHOTHERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1104 E JACKSON ST
MEDFORD OR
97504-7029
US

IV. Provider business mailing address

57 GOLDEN SPIKE WAY
ASHLAND OR
97520-2134
US

V. Phone/Fax

Practice location:
  • Phone: 888-556-7282
  • Fax: 458-203-5051
Mailing address:
  • Phone: 888-556-7282
  • Fax: 458-203-5051

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: LAURA HICKEY
Title or Position: OWNER
Credential: LCSW
Phone: 541-254-6064