Mr Jeremy T Hickey, LMSW | |
5500 E Kellogg Dr, Wichita, KS 67218-1607 | |
(316) 685-2221 | |
(316) 634-3091 |
Full Name | Mr Jeremy T Hickey |
---|---|
Gender | Male |
Speciality | Social Worker - Clinical |
Location | 5500 E Kellogg Dr, Wichita, Kansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1225077258 | NPI | - | NPPES |
389915 | Other | KS | BLUE CROSS BLUE SHIELD |
8202 | Other | KS | PREFERRED HEALTH SYSTEMS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 4022 (Kansas) | Primary |
104100000X | Social Worker | 5448 (Kansas) | Secondary |
Entity Name | Willow Tree Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306233077 PECOS PAC ID: 1658686324 Enrollment ID: O20150811004067 |
Mailing Address | Practice Location Address |
---|---|
Mr Jeremy T Hickey, LMSW 5500 E Kellogg Dr, Wichita, KS 67218-1607 Ph: (316) 685-2221 | Mr Jeremy T Hickey, LMSW 5500 E Kellogg Dr, Wichita, KS 67218-1607 Ph: (316) 685-2221 |
Michael B Bonebrake, LSCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 240 N Rock Road, Suite 303, Wichita, KS 67206 Phone: 316-683-3841 Fax: 316-686-7366 | |
Teresa June Kelzer, LSCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 10209 W Central Ave, Suite 301, Wichita, KS 67212 Phone: 316-737-0544 Fax: 316-943-1773 | |
Mrs. Marcia Simoneau, LSCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 333 S Greenwood St, Wichita, KS 67211 Phone: 316-264-8800 Fax: 316-264-8809 | |
Teresa Obrien, LSCSW, LCSW-R Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1234 N Emporia Ave, Wichita, KS 67214 Phone: 316-282-4985 | |
Mrs. Leelin Tayag Day, LSCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 6611 E Central Ave Ste C, Wichita, KS 67206 Phone: 316-648-1157 Fax: 866-316-4467 | |
Naomi Lee Anderson, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 9429 E Shannon Way Ct, Wichita, KS 67206 Phone: 316-634-1192 | |
Elizabeth J Rempel, LMSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 2318 E Central Ave, Wichita, KS 67214 Phone: 316-262-2415 Fax: 316-262-0138 |