Provider Demographics
NPI:1134011828
Name:HICKS, QUYNH MONG (LCSW)
Entity type:Individual
Prefix:
First Name:QUYNH
Middle Name:MONG
Last Name:HICKS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5870 MILLER RD
Mailing Address - Street 2:
Mailing Address - City:NEW TRIPOLI
Mailing Address - State:PA
Mailing Address - Zip Code:18066-2300
Mailing Address - Country:US
Mailing Address - Phone:484-274-1476
Mailing Address - Fax:
Practice Address - Street 1:2830 EASTON AVE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-4204
Practice Address - Country:US
Practice Address - Phone:484-822-7827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0260461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical