SHANNON HICKS (NPI# 1417295320) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417295320 |
| Entity Type | Individual |
| Full Name | SHANNON HICKS |
| Credential | L.C.S.W, L.C.A.C. |
| Practice Address |
7136 Gettysburg Pike Fort Wayne IN 46804-5680 |
| Practice Telephone | 2607453231 |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2013-01-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
87001417A | IN | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
34006343A | IN | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871143685 | Shannon Marie Hicks | Nurse Practitioner | 1109 Randolph St, Traverse City, MI 49684-2122 | 2019-09-13 |
| 1104144286 | Shannon Ashley Hicks | Social Worker | 45 Willow Street, Springfield, MA 01103 | 2010-05-13 |
| 1104944883 | Shannon Camp Hicks | Counselor | 1202 N Stateline, Texarkana, AR 71854-4969 | 2007-03-27 |
| 1154460038 | Shannon Hicks | Speech-Language Pathologist | 10121 Comanche Rd Ne, Mitchell Es, Albuquerque, NM 87111-3614 | 2007-02-06 |
| 1790136901 | Shannon T. Hicks | Pediatrics | 846 Lake Howell Rd, Maitland, FL 32751-5222 | 2016-06-29 |
| 1700131414 | Shannon Miller Hicks | Physical Therapist | 6041 Garners Ferry Rd, Suite B, Columbia, SC 29209-1304 | 2012-07-18 |
| 1679835375 | Shannon Lynn Hicks | Case Manager/Care Coordinator | 721 Highway 46 S, Dickson, TN 37055-2565 | 2012-06-09 |
| 1366691917 | Shannon Kathleen Hicks | Dentist | 800 Zeagler Dr, Suite 330, Palatka, FL 32177-3883 | 2008-09-18 |
| 1659558005 | Shannon Troy Hicks | Recreation Therapist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2008-01-29 |
| 1275637613 | Shannon Ann Hicks | Counselor | 2750 S 8th St, Beaumont, TX 77701-7719 | 2006-09-07 |
| Street Address |
7136 GETTYSBURG PIKE |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-5680 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497170427 | Crosswinds Inc | Counselor | 7136 Gettysburg Pike, Fort Wayne, IN 46804-5680 | 2014-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154933299 | Kristina Lynn Devors | Social Worker | 7116 Chippenham Dr, Fort Wayne, IN 46818-0033 | 2020-08-19 |
| 1023636909 | Gary Scott Ralya | Social Worker | 2121 E State Blvd, Fort Wayne, IN 46805-4640 | 2020-07-08 |
| 1003444985 | Courageous Healing Inc | Social Worker | 2013 S Anthony Blvd, Fort Wayne, IN 46803-3609 | 2020-03-27 |
| 1164060653 | Brosh Inc | Social Worker | 4820 Oak Knob Run, Fort Wayne, IN 46845-8939 | 2019-12-15 |
| 1740780204 | Jay Bastian LLC | Social Worker | 9910 Dupont Circle Dr. Suite 140, Fort Wayne, IN 46825-1610 | 2018-02-20 |
| 1790291755 | Resolutions Counseling LLC | Social Worker | 13207 Hammerhill Way, Fort Wayne, IN 46845-2351 | 2017-12-28 |
| 1295256907 | Kimberly Ann Bailey | Social Worker | 5310 Merchandise Dr., Fort Wayne, IN 46814 | 2017-07-03 |
| 1306377304 | Charla Leman | Social Worker | 8011 Basswood Pl, Fort Wayne, IN 46835-4752 | 2017-03-22 |
| 1659826055 | Frank Deisler | Social Worker | 5543 S Wayne Ave, Fort Wayne, IN 46807-3128 | 2016-08-16 |
| 1013376458 | Rikki Lynn Treesh | Social Worker | 4918 Canterbury Dr, Fort Wayne, IN 46835-4102 | 2016-02-13 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
Please comment or provide details below to improve the information on SHANNON HICKS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.