Individual
MS. JUDY B HICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC I/QMHA-R
Contact information
Practice address
17645 NW SAINT HELENS RD, PORTLAND, OR 97231-1729
(503) 621-1069
(503) 621-0200
Mailing address
211 SE CARUTHERS ST, PORTLAND, OR 97214-4502
(503) 224-1044
(971) 260-0355
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12-12-28
OR
101YM0800X
Mental Health Counselor
25-QMHA-R-6983
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500744171
—
OR
Enumeration date
05/30/2018
Last updated
02/04/2026
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