| Doctor Name: | MR. JAMES HICKS |
| NPI Number: | 1023031648 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSW, LCSW |
| License Number: | 000487 |
| Business Practice Address: | 5460 Mystic Oaks Drive Imperial, MO - 630523433 |
| Business Phone Number: | 6364679800 |
| Business Fax Number: | |
| Mailing Address: | Po Box 150392, SAINT LOUIS |
| State: | MO |
| Postal Code: | 631158392 |
| Phone Number: | 3145244236 |
| Fax Number: | |
| NPI Enumeration Date: | 07/25/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 000487 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |