Hicks, Wallace Kent

Hicks, Wallace Kent is an individual health care provider with primary practice located at 7400 New La Grange Rd Ste 312, Louisville KY 40222-4870. He recently has only one registered license in Behavioral Health & Social Service Providers / Counseling, which is considered as his primary health care specialty. Hicks, Wallace Kent can be contacted via phone (502) 394-9990.

Contact Information

Primary practice address
7400 New La Grange Rd Ste 312 Louisville KY 40222-4870
Phone: (502) 394-9990
Fax: (502) 394-9992
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counseling 103TC1900X KY 0227 Kentucky

Profile Details

NPI number 1356320212
LBN Legal business name Hicks, Wallace Kent
Credentials ED.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2006
Last updated Jan 6th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356320212 NPPES
Kentucky Other 009407 VALUE OPTIONS
Kentucky Other 179497 VALUE OPTIONS
Kentucky Other 4139574 VALUE OPTIONS
Kentucky Other 4716671 VALUE OPTIONS
Kentucky MEDICAID 89002273 VALUE OPTIONS
Kentucky Other 130222 VALUE OPTIONS
Kentucky Other 461331000 VALUE OPTIONS
Kentucky Other 1058075 VALUE OPTIONS
Kentucky Other 6162200 VALUE OPTIONS
Kentucky Other 93040 VALUE OPTIONS
Kentucky Other 000000342982 VALUE OPTIONS

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