Provider Demographics
NPI:1982824868
Name:HICKOK, ALAN BRUCE SR (LPC)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:BRUCE
Last Name:HICKOK
Suffix:SR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HIGHGATE DR
Mailing Address - Street 2:APT #410
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-2030
Mailing Address - Country:US
Mailing Address - Phone:609-529-7526
Mailing Address - Fax:
Practice Address - Street 1:1 HIGHGATE DR
Practice Address - Street 2:APT #410
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08618-2030
Practice Address - Country:US
Practice Address - Phone:609-529-7526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00100200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health