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NPI Code Detail

MEDICARE: HICKORY LEARNING GROUP LLC

MEDICARE: HICKORY LEARNING GROUP LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst
2103T00000XPsychologist
3251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1376242859
Entity Type Code : Organization
Provider Name (Legal Business Name) : HICKORY LEARNING GROUP LLC
Provider Business Mailing Address
First Line : 3628 26TH STREET DR NE
Second Line :
City : HICKORY
State : NC
Zip : 28601-7206
Country : US
Telephone Number : 201-264-2570
Fax Number :
Provider Business Practice Location Address
First Line : 3628 26TH STREET DR NE
Second Line :
City : HICKORY
State : NC
Zip : 28601-7206
Country : US
Telephone Number : 828-459-6003
Fax Number :
Authorized Official
Title or Position : OWNER
Name : SEAN YOCUM
Credential : BCBA
Telephone Number : 828-459-6003
Provider Enumeration Date : 02/23/2023
Last Update Date : 07/24/2025

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