Provider Demographics
NPI:1326317918
Name:HICKS, ZOHAR SHOSHANNA (LMFT)
Entity Type:Individual
Prefix:
First Name:ZOHAR
Middle Name:SHOSHANNA
Last Name:HICKS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 E 12TH ST APT 13
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-3872
Mailing Address - Country:US
Mailing Address - Phone:310-968-4502
Mailing Address - Fax:
Practice Address - Street 1:510 E 12TH ST APT 13
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-3872
Practice Address - Country:US
Practice Address - Phone:310-968-4502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000909106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist