Shannon Hickey, LCSW | |
11050 Mount Belvedere Blvd, Fort Drum, NY 13602-5438 | |
(315) 772-2015 | |
Not Available |
Full Name | Shannon Hickey |
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Gender | Female |
Speciality | Social Worker |
Location | 11050 Mount Belvedere Blvd, Fort Drum, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1376086488 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 089654-01 (New York) | Secondary |
104100000X | Social Worker | 089654-01 (New York) | Primary |
Entity Name | River Hospital Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003814641 PECOS PAC ID: 2567372899 Enrollment ID: O20040614001352 |
Mailing Address | Practice Location Address |
---|---|
Shannon Hickey, LCSW 11050 Mount Belvedere Blvd, Fort Drum, NY 13602-5438 Ph: (315) 772-0215 | Shannon Hickey, LCSW 11050 Mount Belvedere Blvd, Fort Drum, NY 13602-5438 Ph: (315) 772-2015 |
Ms. Mary Angela Macculloch, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 11050 Mount Belvedere Blvd, Fort Drum, NY 13602 Phone: 315-772-7624 | |
Madison German, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 11050 Mount Belvedere Blvd, Fort Drum, NY 13602 Phone: 315-772-2778 | |
Brittney Welborn, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1st Street West, P36, Fort Drum, NY 13602 Phone: 315-772-2873 | |
Mr. John W Cadin, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 11050 Mount Belvedere Blvd, Usa Meddaccredentials, Fort Drum, NY 13602 Phone: 315-772-4025 Fax: 315-772-9498 | |
Carolyn Munich, LSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 11050 Mount Belvedere Blvd, Fort Drum, NY 13602 Phone: 315-772-0977 | |
Jean Reynolds Truitt, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 11050 Mount Belvedere Blvd, Usa Meddac/credentials, Fort Drum, NY 13602 Phone: 315-772-4025 Fax: 315-772-9498 | |
Semaj Talina Grant, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: Usa Meddac, 11050 Mount Belvedere Blvd, Fort Drum, NY 13602 Phone: 315-772-2557 |