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General NPI Number Information
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NPI Number | 1245877216
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Entity Type | Individual
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Provider Name | STEPHANIE LYNN HICKS LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/09/2019
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 1050 OLD CAMP RD STE 100
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City | THE VILLAGES
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State | FL
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Zip | 32162-1762
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Country | US
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Telephone | 352-674-1760
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Fax |
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Provider Business Mailing Address
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Address Line | 3834 WENDY BLVD
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City | LADY LAKE
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State | FL
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Zip | 32159
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Country | US
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Telephone | 352-636-3231
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Fax |
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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 | SW14422
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License Number State | FL
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