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General NPI Number Information
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NPI Number | 1407399561
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Entity Type | Individual
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Provider Name | PATRICIA HICKS LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 11/22/2016
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Last Update Date | 11/22/2016
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Provider Practice Location Address
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Address Line | 2759 DELK RD SE STE 1200
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City | MARIETTA
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State | GA
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Zip | 30067-8874
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Country | US
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Telephone | 678-401-4596
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Fax | 678-401-3126
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Provider Business Mailing Address
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Address Line | 2759 DELK RD SE STE 1200
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City | MARIETTA
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State | GA
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Zip | 30067-8874
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Country | US
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Telephone | 678-401-4596
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Fax | 678-401-3126
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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 | LPC008826
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPC008826
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License Number State | GA
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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 | LPC008826
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC008826
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LPC008826
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License Number State | GA
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