Individual
DARLENE HICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDC III
Contact information
Practice address
1302 WINSLOW AVENUE, CLEVELAND, OH 44113
(216) 727-2057
(216) 771-1563
Mailing address
1320 WASHINGTON AVENUE, CLEVELAND, OH 44113
(216) 781-0550
(216) 781-7501
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0.151168
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
161608
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0.151168
OHIO CHEMICAL DEPENDENCY PROFESSIONALS BOARD
OH
05
—
0282029
—
OH
Enumeration date
09/21/2017
Last updated
06/29/2018
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