Provider Demographics
NPI:1962938415
Name:HICKSON, SHERRIE KAY (LPC)
Entity type:Individual
Prefix:MS
First Name:SHERRIE
Middle Name:KAY
Last Name:HICKSON
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 1:5790 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:FERRUM
Mailing Address - State:VA
Mailing Address - Zip Code:24088-4271
Mailing Address - Country:US
Mailing Address - Phone:304-922-0400
Mailing Address - Fax:
Practice Address - Street 1:290 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:VA
Practice Address - Zip Code:24151-1709
Practice Address - Country:US
Practice Address - Phone:540-483-0312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007087101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional