Provider Demographics
NPI:1942209861
Name:BICKERS, JAMES F IV (LMFT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:F
Last Name:BICKERS
Suffix:IV
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3229
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31604-3229
Mailing Address - Country:US
Mailing Address - Phone:229-244-4200
Mailing Address - Fax:229-244-4995
Practice Address - Street 1:3541 N CROSSING CIR
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1019
Practice Address - Country:US
Practice Address - Phone:229-244-4200
Practice Address - Fax:229-244-4995
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000812106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist