MEDICARE: AMANDA HICKS M.S., LMFT

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
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1548030430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA HICKS M.S., LMFT

Provider Business Mailing Address
First Line	:	1360 MACKEY BRANCH DR
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-3225
Country	:	US
Telephone Number	:	423-443-3336
Fax Number	:	423-464-7510

Provider Business Practice Location Address
First Line	:	3740 OCOEE PL NW STE 101
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-5635
Country	:	US
Telephone Number	:	423-443-3336
Fax Number	:	423-464-7510

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2024
Last Update Date	:	03/30/2026

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