Provider Demographics
NPI:1407476674
Name:HICKER, ERYN ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:ERYN
Middle Name:ELIZABETH
Last Name:HICKER
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 1:1220 NE 143RD ST APT 215G
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-3151
Mailing Address - Country:US
Mailing Address - Phone:206-631-1040
Mailing Address - Fax:
Practice Address - Street 1:1220 NE 143RD ST APT 215G
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-3151
Practice Address - Country:US
Practice Address - Phone:206-631-1040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-17
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.20021341041C0700X
IDLCSW-386181041C0700X
WALW607131511041C0700X
IN34008828A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical