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NPI Code Detail

MEDICARE: SUSAN JILL HICKS MSW

MEDICARE: SUSAN JILL HICKS MSW
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
1101YM0800XMental Health Counselor
2104100000XSocial Worker

General Provider Information

NPI Number : 1760457402
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN JILL HICKS MSW
Provider Business Mailing Address
First Line : 3458 NEELY ROAD
Second Line :
City : JBMDL
State : NJ
Zip : 08641-2234
Country : US
Telephone Number : 609-754-9324
Fax Number :
Provider Business Practice Location Address
First Line : 3458 NEELY RD
Second Line :
City : JB MDL
State : NJ
Zip : 08641-5312
Country : US
Telephone Number : 609-754-9324
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2006
Last Update Date : 12/15/2021

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Directions to “ SUSAN JILL HICKS MSW” Practice Location

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