Provider Demographics
NPI:1033803929
Name:HICKS, JENNIFER (LCMHC, NCC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:HICKS
Suffix:
Gender:F
Credentials:LCMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-9127
Mailing Address - Country:US
Mailing Address - Phone:704-438-4342
Mailing Address - Fax:
Practice Address - Street 1:124 E NORTH ST
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-4048
Practice Address - Country:US
Practice Address - Phone:704-985-1088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2025-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18804101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health