Provider Demographics
NPI:1275082380
Name:HICKEN, ANNA (LPCA)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:HICKEN
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N GREENSBORO ST
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-1833
Mailing Address - Country:US
Mailing Address - Phone:919-381-6068
Mailing Address - Fax:
Practice Address - Street 1:200 N GREENSBORO ST
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-1833
Practice Address - Country:US
Practice Address - Phone:919-381-6068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-30
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA12466101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health