Provider Demographics
NPI:1346428794
Name:HICKS, KARA LYNN (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:LYNN
Last Name:HICKS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W BROADWAY STE F
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-3842
Mailing Address - Country:US
Mailing Address - Phone:573-214-0436
Mailing Address - Fax:573-442-0606
Practice Address - Street 1:2200 NW CORPORATE BLVD STE 300
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7307
Practice Address - Country:US
Practice Address - Phone:561-955-6090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-07
Last Update Date:2022-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20150227311041C0700X
OHI.09000161041C0700X
FLSW183961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical