Provider Demographics
NPI:1770312928
Name:HICKEY, BRANDON JAY (MSW, LSW)
Entity type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:JAY
Last Name:HICKEY
Suffix:
Gender:M
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 PEACHTREE VLG
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-4513
Mailing Address - Country:US
Mailing Address - Phone:973-919-2193
Mailing Address - Fax:
Practice Address - Street 1:380 FOOTHILL RD
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2255
Practice Address - Country:US
Practice Address - Phone:908-428-0995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-27
Last Update Date:2024-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL07129100104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker