Provider Demographics
NPI:1194921908
Name:HICKEIN, KARIANN (LCSW-R)
Entity type:Individual
Prefix:
First Name:KARIANN
Middle Name:
Last Name:HICKEIN
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 HOLLYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14221-3825
Mailing Address - Country:US
Mailing Address - Phone:716-730-9650
Mailing Address - Fax:
Practice Address - Street 1:338 HARRIS HILL RD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14221-7470
Practice Address - Country:US
Practice Address - Phone:716-906-8833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NYP067453-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RA1398Medicare ID - Type Unspecified