| Elaine Hicks Llc | |
|
91-1265 Kamaaha Ave Apt 507 Kapolei HI 96707-4917 | |
| (808) 675-1086 | |
| Not Available |
| Full Name | Elaine Hicks Llc |
|---|---|
| Speciality | Social Worker |
| Location | 91-1265 Kamaaha Ave Apt 507, Kapolei, Hawaii |
| Authorized Official Name and Position | Elaine Lelanda Hicks (LCSW, OWNER) |
| Authorized Official Contact | 8086751086 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elaine Hicks Llc 91-1265 Kamaaha Ave Apt 507 Kapolei HI 96707-4917 Ph: (808) 675-1086 | Elaine Hicks Llc 91-1265 Kamaaha Ave Apt 507 Kapolei HI 96707-4917 Ph: (808) 675-1086 |
| NPI Number | 1710563721 |
|---|---|
| Provider Enumeration Date | 03/20/2021 |
| Last Update Date | 12/10/2021 |
| Certification Date | 12/08/2021 |
| Medicare PECOS PAC ID | 7012309495 |
|---|---|
| Medicare Enrollment ID | O20220114000991 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710563721 | NPI | - | NPPES |
| 15107328 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Elaine Lelanda Hicks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306437058 PECOS PAC ID: 1658789078 Enrollment ID: I20210422002416 |
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