Provider Demographics
NPI:1962291955
Name:HICKEY, XIOMARA (MHCI)
Entity type:Individual
Prefix:MRS
First Name:XIOMARA
Middle Name:
Last Name:HICKEY
Suffix:
Gender:
Credentials:MHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1952 LEGACY COVE DR # 1952
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7523
Mailing Address - Country:US
Mailing Address - Phone:407-860-7605
Mailing Address - Fax:
Practice Address - Street 1:1952 LEGACY COVE DR # 1952
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7523
Practice Address - Country:US
Practice Address - Phone:407-860-7605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH24683101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health