Provider Demographics
NPI:1487038063
Name:HICKS, KAYLA LEANN (MSW,, LMHC)
Entity Type:Individual
Prefix:MISS
First Name:KAYLA
Middle Name:LEANN
Last Name:HICKS
Suffix:
Gender:F
Credentials:MSW,, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31235
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-3020
Mailing Address - Country:US
Mailing Address - Phone:509-505-6006
Mailing Address - Fax:509-232-6572
Practice Address - Street 1:4707 E 44TH LN
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-2258
Practice Address - Country:US
Practice Address - Phone:509-505-6006
Practice Address - Fax:509-232-6572
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60831379101YM0800X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical