Provider Demographics
NPI:1689371734
Name:HUCKABY, JAMIE DENISE (LCSW)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:DENISE
Last Name:HUCKABY
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 1:425 N HIGHLAND AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-7377
Mailing Address - Country:US
Mailing Address - Phone:903-957-0082
Mailing Address - Fax:903-957-0351
Practice Address - Street 1:425 N HIGHLAND AVE STE 260
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-7377
Practice Address - Country:US
Practice Address - Phone:903-957-0082
Practice Address - Fax:903-957-0351
Is Sole Proprietor?:No
Enumeration Date:2023-02-09
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX671191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical