Individual
WALLACE KENT HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
7400 NEW LA GRANGE RD, STE 312, LOUISVILLE, KY 40222-4870
(502) 394-9990
(502) 394-9992
Mailing address
7400 NEW LA GRANGE RD, STE 312, LOUISVILLE, KY 40222-4870
(502) 394-9990
(502) 394-9992
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
KY 0227
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000342982
ANTHEM
KY
01
—
009407
VALUE OPTIONS
KY
01
—
1058075
CIGNA BEHAVIORAL HEALTH
KY
01
—
130222
APS
KY
01
—
179497
COMPSYCH
KY
01
—
4139574
AETNA
KY
01
—
461331000
MAGELLAN
KY
01
—
4716671
CIGNA HEALTHCARE
KY
01
—
6162200
UNITED BEHAVIORAL HEALTH
KY
05
—
89002273
—
KY
01
—
93040
MHN
KY
Enumeration date
01/10/2006
Last updated
01/06/2011
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