MEDICARE: JENNIFER JONES-HICKS MA, CCC-SLP

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	235Z00000X	Speech-Language Pathologist	123214	TX
2	235Z00000X	Speech-Language Pathologist	2202008044	VA
3	252Y00000X	Early Intervention Provider Agency		VA

General Provider Information

NPI Number	:	1790132173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER JONES-HICKS MA, CCC-SLP

Provider Business Mailing Address
First Line	:	67 RED ROBIN TURN
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23669-5914
Country	:	US
Telephone Number	:	757-880-2468
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 ENTERPRISE PKWY STE 315
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23666-5845
Country	:	US
Telephone Number	:	757-260-5507
Fax Number	:	757-208-1046

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

Provider Enumeration Date	:	05/16/2016
Last Update Date	:	01/07/2026

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