Individual
MR. HERBERT GRANT HICKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PLPC
Contact information
Practice address
100 POYDRAS ST, LAFAYETTE, LA 70501-4740
(337) 231-6365
Mailing address
100 POYDRAS ST, LAFAYETTE, LA 70501-4740
(337) 231-6365
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3257
LA
101YM0800X
Mental Health Counselor
Primary
6210
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6210
LPC BOARD
LA
Enumeration date
11/25/2015
Last updated
11/25/2015
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