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General NPI Number Information
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NPI Number | 1255074993
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Entity Type | Individual
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Provider Name | JOSEPH MAURICE HICKS PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 04/20/2022
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 305 MARSH VIEW CT
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City | CARROLLTON
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State | VA
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Zip | 23314-2243
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Country | US
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Telephone | 808-372-9615
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 74
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City | CARROLLTON
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State | VA
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Zip | 23314-0074
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Country | US
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Telephone | 948-867-3889
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024184166
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | 0024184166
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 0024184166
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 364SP0811X
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Taxonomy Name | Chronically Ill Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 0024184166
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License Number State | VA
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