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General NPI Number Information
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NPI Number | 1891176608
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Entity Type | Individual
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Provider Name | BRIANNA HICKS LCMHC
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Gender | Female
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Dates
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Enumeration Date | 06/17/2015
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 128 E HARGETT ST STE 309
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City | RALEIGH
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State | NC
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Zip | 27601-1460
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Country | US
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Telephone | 919-617-1001
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Fax |
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Provider Business Mailing Address
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Address Line | 300 W HARGETT ST UNIT 632
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City | RALEIGH
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State | NC
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Zip | 27601-3022
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Country | US
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Telephone | 860-377-9449
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 14374
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License Number State | NC
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