1033744750 NPI number — ASHLEY NICOLE HICKMAN LPCC, NCC

Table of content: ASHLEY NICOLE HICKMAN LPCC, NCC (NPI 1033744750)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033744750 NPI number — ASHLEY NICOLE HICKMAN LPCC, NCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HICKMAN
Provider First Name:
ASHLEY
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPCC, NCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033744750
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 735
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GALION
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44833-0735
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-777-1210
Provider Business Mailing Address Fax Number:
419-948-4141

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
777 FAIRVIEW AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GALION
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44833-1834
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-777-1210
Provider Business Practice Location Address Fax Number:
419-948-4141
Provider Enumeration Date:
03/04/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  C.2002556 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: E.2202839 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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