Provider Demographics
NPI:1194735928
Name:HICKSON, JULIE (LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:HICKSON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 ANDREW CT
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21617-2539
Mailing Address - Country:US
Mailing Address - Phone:410-758-4800
Mailing Address - Fax:443-262-9697
Practice Address - Street 1:605 MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21666-2029
Practice Address - Country:US
Practice Address - Phone:410-758-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD108661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical