Doctor Name: | GREGORY A HICKEL |
NPI Number: | 1578765145 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMSW |
License Number: | LMSW 1925 |
Business Practice Address: | 610 N Hirsch Ave Ellinwood, KS - 675261433 |
Business Phone Number: | 6205643069 |
Business Fax Number: | 6205643069 |
Mailing Address: | 900 W Broadway St, NEWTON |
State: | KS |
Postal Code: | 671142037 |
Phone Number: | 3162831950 |
Fax Number: | 3162839540 |
NPI Enumeration Date: | 06/04/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LMSW 1925 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |