Healthcare Provider Details

I. General information

NPI: 1639997232
Provider Name (Legal Business Name): SANDRA HICKEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2024
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 DRAKE RD STE E
PITTSBURGH PA
15241-1556
US

IV. Provider business mailing address

101 DRAKE RD STE E
PITTSBURGH PA
15241-1556
US

V. Phone/Fax

Practice location:
  • Phone: 412-945-0692
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: