Provider Demographics
NPI:1376161083
Name:SIKOCHI, HILARY ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:HILARY
Middle Name:ANN
Last Name:SIKOCHI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:884 W SAGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:STANSBURY PARK
Mailing Address - State:UT
Mailing Address - Zip Code:84074-4921
Mailing Address - Country:US
Mailing Address - Phone:801-448-6523
Mailing Address - Fax:
Practice Address - Street 1:1244 N MAIN ST
Practice Address - Street 2:
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-9838
Practice Address - Country:US
Practice Address - Phone:801-448-6523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-09
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9735698-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1376161083Medicaid