Provider Demographics
NPI:1801003413
Name:HICKS, ROBYN LAVERNE LEE (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:LAVERNE LEE
Last Name:HICKS
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 1:6801 SANGER AVE
Mailing Address - Street 2:STE 188-C
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-7818
Mailing Address - Country:US
Mailing Address - Phone:254-304-9309
Mailing Address - Fax:
Practice Address - Street 1:6801 SANGER AVE
Practice Address - Street 2:STE 188-C
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-7818
Practice Address - Country:US
Practice Address - Phone:254-304-9309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4978C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical