Provider Demographics
NPI:1740559798
Name:HICKEY, MALAINA FRANCES (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MALAINA
Middle Name:FRANCES
Last Name:HICKEY
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 1:211 MOCKINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:ALEDO
Mailing Address - State:TX
Mailing Address - Zip Code:76008-4567
Mailing Address - Country:US
Mailing Address - Phone:817-800-2140
Mailing Address - Fax:
Practice Address - Street 1:4410 W VICKERY BLVD STE 204
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-6256
Practice Address - Country:US
Practice Address - Phone:682-300-4158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-20
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
TX516061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical