Provider Demographics
NPI:1215642574
Name:HICKS, COURTNEY AMANDA (LPC)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:AMANDA
Last Name:HICKS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 W VIRGINIA ST STE 203J
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-4421
Mailing Address - Country:US
Mailing Address - Phone:972-836-6221
Mailing Address - Fax:
Practice Address - Street 1:109 W VIRGINIA ST STE 203J
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-4421
Practice Address - Country:US
Practice Address - Phone:972-836-6221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-20
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85566101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional