Provider Demographics
NPI:1184952665
Name:HICKS, HELEN V (MA, LPC)
Entity type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:V
Last Name:HICKS
Suffix:
Gender:F
Credentials:MA, LPC
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 2123
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-8123
Mailing Address - Country:US
Mailing Address - Phone:609-238-5120
Mailing Address - Fax:866-288-5024
Practice Address - Street 1:1155 ROUTE 73
Practice Address - Street 2:RAMBLEWOOD STE 12
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-2352
Practice Address - Country:US
Practice Address - Phone:609-238-5120
Practice Address - Fax:866-288-5024
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-22
Last Update Date:2009-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00387400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ11997663OtherCAQH