Provider Demographics
NPI:1821542903
Name:HICKS, BRIANNA JOY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BRIANNA
Middle Name:JOY
Last Name:HICKS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:BRIANNA
Other - Middle Name:JOY
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:5408 CHAMBERLAYNE RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-2407
Mailing Address - Country:US
Mailing Address - Phone:804-272-2000
Mailing Address - Fax:804-272-2030
Practice Address - Street 1:3415 BRYSON DR
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-1431
Practice Address - Country:US
Practice Address - Phone:540-598-8770
Practice Address - Fax:804-765-5536
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-07
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040084681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical