Individual
KENNETH HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., LCSW
Contact information
Practice address
308 EAST 21ST AVENUE, GARY, IN 46407
(219) 886-1320
(219) 886-1319
Mailing address
9323 SOUTH EMERALD AVENUE, CHICAGO, IL 60620
(773) 858-6999
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
IL
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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