Individual
MR. JASON T HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, LCSW
Contact information
Practice address
1 S CREEK DR STE 102, MONTICELLO, KY 42633-9472
(606) 348-3365
(606) 348-8496
Mailing address
1 S CREEK DR STE 102, MONTICELLO, KY 42633-9472
(606) 348-3365
(606) 348-8496
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2011
KY
363LF0000X
Family Nurse Practitioner
Primary
3008758
KY
Other
Enumeration date
04/11/2008
Last updated
01/31/2020
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