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General NPI Number Information
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NPI Number | 1295109973
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Entity Type | Individual
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Provider Name | TERA LYNN HICKS LPCC
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Gender | Female
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Dates
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Enumeration Date | 11/18/2015
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Last Update Date | 12/26/2018
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Provider Practice Location Address
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Address Line | 1000 ASHLAND DR STE 301
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City | ASHLAND
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State | KY
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Zip | 41101-7097
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Country | US
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Telephone | 606-326-0322
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Fax | 606-326-9809
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Provider Business Mailing Address
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Address Line | 1000 ASHLAND DR STE 301
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City | ASHLAND
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State | KY
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Zip | 41101-7097
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Country | US
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Telephone | 606-326-0322
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Fax | 606-326-9809
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 245080
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License Number State | KY
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