Doctor Name: | DERETHA HICKS-SYKES |
NPI Number: | 1033364872 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 2004033766 |
Business Practice Address: | 904 S 10th St Saint Joseph, MO - 645032405 |
Business Phone Number: | 8162335188 |
Business Fax Number: | 8162322696 |
Mailing Address: | 2303 Village Dr, SAINT JOSEPH |
State: | MO |
Postal Code: | 645064954 |
Phone Number: | 8162718219 |
Fax Number: | 8162322696 |
NPI Enumeration Date: | 11/20/2008 |
NPI Last Update Date: | 06/18/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 2004033766 |
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 |