ROGER ELLIOTT HICKS III (NPI# 1598071490) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1598071490 |
Entity Type | Individual |
Full Name | ROGER ELLIOTT HICKS III |
Credential | PHD |
Practice Address |
2200 Fort Roots Dr # 3d North Little Rock AR 72114 |
Mailing Address |
2200 Fort Roots Dr # 3d North Little Rock AR 72114-1709 |
Practice Telephone | 5012573925 |
Mailing Telephone | 5012573925 |
Enumeration Date | 2010-08-30 |
Last Update Date | 2019-09-25 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
Y | 103TC0700X |
Psychologist Specialization: Clinical |
2715 | KS | Behavioral Health & Social Service Providers |
N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
Address | Telephone Number | Fax Number |
---|---|---|
4301 W Markham St, Slot 589, Little Rock, AR 722057101 | 3127478974 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013393164 | Roger Hicks | Massage Therapist | 409 Pine St, 207, Klamath Falls, OR 97601-6020 | 2015-07-30 |
1295908630 | Roger Lowell Hicks | Dentist | 1345 E 3900 S, Suite 216, Salt Lake City, UT 84124-1474 | 2008-04-07 |
1275685901 | Roger D Hicks | Counselor | 605 South Ky Hwy 15, Campton, KY 41301 | 2007-01-16 |
1689605206 | Roger G Hicks | Emergency Medicine | 2090 Nevada City Hwy, Grass Valley, CA 95945-7702 | 2006-07-05 |
Street Address |
2200 FORT ROOTS DR # 3D |
City | NORTH LITTLE ROCK |
State | AR |
Zip Code | 72114 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316432966 | Mid State Counseling and Recovery Service | Clinic/Center | 1920 Main St Ste 229, North Little Rock, AR 72114 | 2018-06-26 |
1053826842 | Kelli Lauron Johnson | Nurse Practitioner | 2800 North Willow Street, North Little Rock, AR 72114 | 2017-12-03 |
1689117756 | State of Arkansas | Skilled Nursing Facility | 2401 John Ashley Drive, Building #100, North Little Rock, AR 72114 | 2016-11-22 |
1366787459 | J Andrew Mccullough | Counselor | 628 W Broadway St Ste 300, North Little Rock, AR 72114 | 2012-11-30 |
1740594456 | Tuyet Thi Van | Dentist | 520 W. Pershing Blvd., North Little Rock, AR 72114 | 2010-08-05 |
1467764183 | Jennifer Leigh Nash | Behavioral Analyst | 628 W Broadway St Ste 100, North Little Rock, AR 72114 | 2010-07-10 |
1336398544 | Tina A Davie | Registered Nurse | 2200 Foot Roots Drive, Little Rock, AR 72114 | 2008-09-11 |
1316125313 | Centers for Youth & Families | Community/Behavioral Health | 200 W. 20th, North Little Rock, AR 72114 | 2008-02-01 |
1881878064 | Marie A Graham | Nurse Practitioner | 636 West Broadway St, No Little Rock, AR 72114 | 2007-12-24 |
1902012297 | Lee Overall | Kinesiotherapist | 2200 Ft Roots Rd, Little Rock, AR 72114 | 2007-05-15 |
Find all providers in zip 72114 |
Taxonomy Code | 103TC0700X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194297648 | John M Ray | Psychologist | 2200 Fort Roots Dr 116b/nlr, North Little Rock, AR 72114-1709 | 2018-12-21 |
1699279158 | Eva N Woodward | Psychologist | 2200 Fort Roots Drive, 152 Nlr, North Little Rock, AR 72114-1709 | 2018-03-20 |
1265853378 | Renee Gibbs | Psychologist | 2200 Fort Roots Dr # 116b, North Little Rock, AR 72114-1709 | 2013-12-17 |
1437429818 | Shanti M Pepper | Psychologist | 2200 Fort Roots Dr Bldg 170116, North Little Rock, AR 72114-1709 | 2012-01-03 |
1407964471 | Stephen F. Daniels | Psychologist | 2200 Ft. Roots Drive, 116d/nlr, North Little Rock, AR 72214 | 2006-08-29 |
1710935218 | Mary Moore Ekdahl | Psychologist | 4004 Mccain Blvd, Suite 203, North Little Rock, AR 72116-8057 | 2006-05-05 |
1285118943 | Leticia Duvivier | Psychologist | 2200 Fort Roots Dr, North Little Rock, AR 72114-1709 | 2018-09-19 |
1710485115 | Stephanie Catherine Raducha | Psychologist | 2200 Fort Roots Dr, 116b/nlr, North Little Rock, AR 72114 | 2018-01-31 |
1386002673 | Alissa Kolb | Psychologist | 2200 Fort Roots Dr, North Little Rock, AR 72114-1709 | 2016-02-02 |
1245609155 | Katherine Green Pope | Psychologist | 1301 Main St, North Little Rock, AR 72114-4126 | 2015-09-21 |
Find all providers in NORTH LITTLE ROCK |
City | NORTH LITTLE ROCK |
Zip Code | 72114 |
Please comment or provide details below to improve the information on ROGER ELLIOTT HICKS III.
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.