Provider Demographics
NPI:1568288710
Name:MARKAY HICKERSON, LCSW, PLLC
Entity type:Organization
Organization Name:MARKAY HICKERSON, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARKAY
Authorized Official - Middle Name:
Authorized Official - Last Name:HICKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:903-215-3799
Mailing Address - Street 1:2503 NORTHHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-2345
Mailing Address - Country:US
Mailing Address - Phone:903-215-3799
Mailing Address - Fax:
Practice Address - Street 1:1221 JUDSON RD STE 100
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-3922
Practice Address - Country:US
Practice Address - Phone:903-215-3799
Practice Address - Fax:903-616-8017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty