Provider Demographics
NPI:1114183746
Name:WILLIAMS-HICKSON, ALICIA RENA (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:RENA
Last Name:WILLIAMS-HICKSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 PHYLLIS LN
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727-2718
Mailing Address - Country:US
Mailing Address - Phone:631-846-3501
Mailing Address - Fax:631-846-3501
Practice Address - Street 1:790 PARK AVE
Practice Address - Street 2:FAMILY SERVICE LEAGUE
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743
Practice Address - Country:US
Practice Address - Phone:631-369-0104
Practice Address - Fax:631-369-5433
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071033-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical