Individual
IVY ICKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4131 S BRAESWOOD BLVD, HOUSTON, TX 77025-3306
(713) 667-9336
Mailing address
4331 ROBERTSON ST, HOUSTON, TX 77009-4127
(832) 795-1435
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/30/2009
Last updated
04/01/2022
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