Provider Demographics
NPI:1639897796
Name:HICKS, ROBIN MARANDA (LPCC)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:MARANDA
Last Name:HICKS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:MARANDA
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ROBIN HICKS MA, LPCC
Mailing Address - Street 1:4536 58TH AVE N APT 239
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55429-2994
Mailing Address - Country:US
Mailing Address - Phone:520-987-3196
Mailing Address - Fax:
Practice Address - Street 1:6550 YORK AVE S STE 417
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2336
Practice Address - Country:US
Practice Address - Phone:952-426-3034
Practice Address - Fax:612-801-7177
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3455101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional