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:
Health care specialties
Specialty | Code | License # | 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 13 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
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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