Provider Demographics
NPI:1437775822
Name:HICKEY, JULIANA M (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JULIANA
Middle Name:M
Last Name:HICKEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JULIANA
Other - Middle Name:M
Other - Last Name:LAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:4880 N SHERMAN STREET EXT
Mailing Address - Street 2:
Mailing Address - City:MOUNT WOLF
Mailing Address - State:PA
Mailing Address - Zip Code:17347-9637
Mailing Address - Country:US
Mailing Address - Phone:717-266-9294
Mailing Address - Fax:717-384-8071
Practice Address - Street 1:4880 N SHERMAN STREET EXT
Practice Address - Street 2:
Practice Address - City:MOUNT WOLF
Practice Address - State:PA
Practice Address - Zip Code:17347-9637
Practice Address - Country:US
Practice Address - Phone:717-266-9294
Practice Address - Fax:717-384-8071
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW020366104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker