Individual
MS. JENNA HICKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
180 BROAD ST APT 1419, STAMFORD, CT 06901-2080
(857) 400-0868
Mailing address
180 BROAD ST APT 1419, STAMFORD, CT 06901-2080
(857) 400-0868
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
125790
MA
1041C0700X
Clinical Social Worker
Primary
14043
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125790
LICSW LICENSE #
MA
01
—
14043
LCSW LICENSE #
CT
Enumeration date
01/25/2022
Last updated
11/07/2024
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