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General NPI Number Information
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NPI Number | 1194723379
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Entity Type | Individual
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Provider Name | MELODY SUZANNE HICKMAN-HORVATH LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 215 HEDRICK DR
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City | NEWPORT
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State | TN
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Zip | 37821-2902
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Country | US
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Telephone | 423-623-5301
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Fax | 423-625-0808
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Provider Business Mailing Address
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Address Line | DEPARTMENT 888182
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City | KNOXVILLE
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State | TN
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Zip | 37995-0001
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Country | US
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Telephone | 800-355-3565
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Fax | 423-714-2355
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW 5982
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LSW4592
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License Number State | TN
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