Provider Demographics
NPI:1356016208
Name:HICKS, SABRINA DANELLE (MSW)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:DANELLE
Last Name:HICKS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:SABRIA
Other - Middle Name:DANELLE
Other - Last Name:HICKS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:137 AUGUSTA AVE
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-7002
Mailing Address - Country:US
Mailing Address - Phone:229-289-3162
Mailing Address - Fax:
Practice Address - Street 1:1114 THOMASVILLE RD STE D
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-6290
Practice Address - Country:US
Practice Address - Phone:850-508-4624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health