Individual
BEVERLY A WICKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LCAS, CCS
Contact information
Practice address
201 SHANNON OAKS CIR STE 200, CARY, NC 27511
(919) 415-4244
(877) 600-5440
Mailing address
345 CARTHAGE ST, SANFORD, NC 27330-4206
(919) 774-1131
(877) 600-5440
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-2039
NC
1041C0700X
Clinical Social Worker
Primary
C006796
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6007548
—
NC
Enumeration date
05/17/2010
Last updated
09/06/2018
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