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General NPI Number Information
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NPI Number | 1093133100
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Entity Type | Individual
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Provider Name | RONALD VINCENT HICKS LCMHC, LCAS, CAMS-II
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Gender | Male
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Dates
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Enumeration Date | 04/04/2014
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Last Update Date | 05/23/2022
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Provider Practice Location Address
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Address Line | 3000 NEW BERN AVE
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City | RALEIGH
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State | NC
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Zip | 27610-1231
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Country | US
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Telephone | 919-350-8000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 602368
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City | CHARLOTTE
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State | NC
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Zip | 28260-2368
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Country | US
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Telephone | 919-350-0351
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Fax | 919-350-7687
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 25073
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | A10700
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 10700
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License Number State | NC
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