Provider Demographics
NPI:1457175168
Name:HICKEY, LAUREN ANNE
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:ANNE
Last Name:HICKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 W MAIN AVE APT 901
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-0664
Mailing Address - Country:US
Mailing Address - Phone:480-239-4470
Mailing Address - Fax:
Practice Address - Street 1:515 W FRANCIS AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6413
Practice Address - Country:US
Practice Address - Phone:509-433-7755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-09
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health