Provider Demographics
NPI:1881851590
Name:HICKS, DAVID D (LBSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:D
Last Name:HICKS
Suffix:
Gender:M
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-4938
Mailing Address - Country:US
Mailing Address - Phone:641-752-2300
Mailing Address - Fax:641-752-4768
Practice Address - Street 1:11 E STATE ST
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-4938
Practice Address - Country:US
Practice Address - Phone:641-752-2300
Practice Address - Fax:641-752-4768
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02714104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker