Provider Demographics
NPI:1841496924
Name:BICKLEY, JONI D (LCSW)
Entity type:Individual
Prefix:
First Name:JONI
Middle Name:D
Last Name:BICKLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 NORTH 100 EAST
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-3091
Mailing Address - Country:US
Mailing Address - Phone:435-586-2515
Mailing Address - Fax:435-865-7606
Practice Address - Street 1:54 N 200 E
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-2615
Practice Address - Country:US
Practice Address - Phone:435-586-2515
Practice Address - Fax:435-865-7606
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4810438-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTTHOMAJOtherSWBHC STAFF CODE
UT4810438-3502OtherCSW LICENSE
UT4810438-3501OtherLCSW LICENSE