Active NPI
Jeffrey Bryan Hickman, LPC
- Professional Counselor
- Jackson, MS
National Provider Identifier
1033394358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1305
- Practice address
- 1551 E County Line Rd
Jackson, MS 39211-1801 - Phone
- (601) 906-0224
- Fax
- (601) 957-7344
- NPI assigned
- Jan 5, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1305 | MS | Primary |
Addresses
Primary practice location
1551 E County Line Rd
Jackson, MS 39211-1801
Mailing address
1551 E County Line Rd
Jackson, MS 39211-1801
Phone (601) 906-0224
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1305 | MS | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376265600000",
"number": "1033394358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1551 E COUNTY LINE RD",
"city": "JACKSON",
"state": "MS",
"postal_code": "392111801",
"telephone_number": "601-906-0224",
"fax_number": "601-957-7344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1551 E COUNTY LINE RD",
"city": "JACKSON",
"state": "MS",
"postal_code": "392111801",
"telephone_number": "601-906-0224",
"fax_number": "601-957-7344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKMAN",
"first_name": "JEFFREY",
"middle_name": "BRYAN",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-05",
"last_updated": "2013-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MS",
"license": "1305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.