Provider Demographics
NPI:1093132805
Name:HICKS, LINDA A (CSAC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:A
Last Name:HICKS
Suffix:
Gender:F
Credentials:CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 COLLEGE PL
Mailing Address - Street 2:SUITE B100
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-2483
Mailing Address - Country:US
Mailing Address - Phone:828-254-5008
Mailing Address - Fax:828-210-2881
Practice Address - Street 1:31 COLLEGE PL
Practice Address - Street 2:SUITE B100
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2483
Practice Address - Country:US
Practice Address - Phone:828-254-5008
Practice Address - Fax:828-210-2881
Is Sole Proprietor?:No
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2293101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)