Individual
CAROLYN LUCINDA HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2486 GILLESPIE ST, FAYETTEVILLE, NC 28306-3023
(910) 568-1183
Mailing address
1687 BLADEN UNION CHURCH RD, FAYETTEVILLE, NC 28306-9428
(910) 568-1183
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
—
—
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
11/26/2018
Last updated
11/26/2018
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