Provider Demographics
NPI:1871894055
Name:HICKS, JOYCE EUNICE (LLMSW)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:EUNICE
Last Name:HICKS
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 W MICHIGAN AVE
Mailing Address - Street 2:STE 802
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-1345
Mailing Address - Country:US
Mailing Address - Phone:517-867-3419
Mailing Address - Fax:517-252-2706
Practice Address - Street 1:180 W MICHIGAN AVE
Practice Address - Street 2:STE 802
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1345
Practice Address - Country:US
Practice Address - Phone:517-867-3419
Practice Address - Fax:517-252-2706
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801092364104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker