Provider Demographics
NPI:1265780365
Name:HICKMAN, ALISON LEE (LCSW)
Entity type:Individual
Prefix:MS
First Name:ALISON
Middle Name:LEE
Last Name:HICKMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 KUHLTHAU AVE
Mailing Address - Street 2:
Mailing Address - City:MILLTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08850-1831
Mailing Address - Country:US
Mailing Address - Phone:908-420-6777
Mailing Address - Fax:
Practice Address - Street 1:46 BAYARD ST STE 215
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2152
Practice Address - Country:US
Practice Address - Phone:908-420-6777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-21
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057209001041C0700X
NY084112-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical