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General NPI Number Information
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NPI Number | 1487734497
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Entity Type | Organization
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Legal Business Name | HICKS COUNSELING SERVS
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 05/17/2013
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Provider Practice Location Address
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Address Line | 690 ANCORD #360
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City | PALESTINE
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State | TX
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Zip | 75803
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Country | US
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Telephone | 903-723-2451
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Fax | 903-723-2471
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Provider Business Mailing Address
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Address Line | POB 563
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City | PALESTINE
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State | TX
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Zip | 75802
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Country | US
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Telephone | 214-557-8961
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Fax | 903-723-2471
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Authorized Official
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Title or Position | HICKS COUNSELING SERVICES
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Name | MRS. MARIAN B HICKS
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Credential | MED LPC LMFT CCJS
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Telephone | 903-723-2451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 3397LMFT
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License Number State | TX
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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 | 11657LPC
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License Number State | TX
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