Provider Demographics
NPI:1083978001
Name:HICKS, ANNA CAROLINE (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:CAROLINE
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 1:21 N SAVANNA DR
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19465-6602
Mailing Address - Country:US
Mailing Address - Phone:412-398-1419
Mailing Address - Fax:
Practice Address - Street 1:11 ROBINSON ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-6421
Practice Address - Country:US
Practice Address - Phone:610-326-9250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0158641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical