Individual
MELISSA JO HICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CAC III
Contact information
Practice address
8801 LIPAN ST, THORNTON, CO 80260-4912
(303) 412-3724
(303) 412-3999
Mailing address
8801 LIPAN ST, THORNTON, CO 80260-4912
(303) 412-3724
(303) 412-3999
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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