Jennifer Hicks, LCSW | |
901 S. Harrill Ave, Wagoner, OK 74467-5867 | |
(918) 485-0242 | |
(918) 485-0204 |
Full Name | Jennifer Hicks |
---|---|
Gender | Female |
Speciality | Social Worker |
Location | 901 S. Harrill Ave, Wagoner, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1669920054 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 7277 (Oklahoma) | Secondary |
104100000X | Social Worker | (* (Not Available)) | Primary |
Entity Name | Millennium Medical Services, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245286285 PECOS PAC ID: 6204730856 Enrollment ID: O20040105000859 |
Entity Name | Grand Lake Mental Health Center, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1497762520 PECOS PAC ID: 4688711534 Enrollment ID: O20091026000174 |
Mailing Address | Practice Location Address |
---|---|
Jennifer Hicks, LCSW 1203 Se 3rd St, Wagoner, OK 74467-5823 Ph: (918) 815-9863 | Jennifer Hicks, LCSW 901 S. Harrill Ave, Wagoner, OK 74467-5867 Ph: (918) 485-0242 |
Lori Kim Childs, LMSW-P Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 109 S Harrill Ave, Wagoner, OK 74467 Phone: 918-485-0242 | |
Ginger L Luna, MSW, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 509 Honeysuckle Dr, Wagoner, OK 74467 Phone: 918-527-9877 |