Provider Demographics
NPI:1104550953
Name:HUCKABY, ALICIA DANIELLE (MS, NCC, LPC-MHSP)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:DANIELLE
Last Name:HUCKABY
Suffix:
Gender:F
Credentials:MS, NCC, LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4011 WHITLOW AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-7674
Mailing Address - Country:US
Mailing Address - Phone:423-920-2063
Mailing Address - Fax:
Practice Address - Street 1:1501 KIRBY RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2854
Practice Address - Country:US
Practice Address - Phone:865-309-5848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6050101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health