Individual provider Active NPI

Angela Njideka Hicks, LCSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1053022186
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
65489 Issued in TX
Practice address
12505 Memorial Dr
Houston, TX 77024-6051
Phone
(832) 883-5156
NPI assigned
Dec 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 65489 TX Primary

Addresses

Primary practice location

12505 Memorial Dr
Houston, TX 77024-6051

Mailing address

PO Box 420151
Houston, TX 77242-0151
Phone (832) 883-5156

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230106000718 TX Practitioner - Clinical Social Worker 2365812468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progressive Behavioral Health, PLLCGroup PAC ID 4486794906, 366 clinicians

Practice addresses (Care Compare)

12505 Memorial Dr
Suite 230
Houston, TX 77024-6051
Phone (844) 824-8775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Behavioral Health, PLLC Mental Health CurrentSince Dec 27, 2022 Accepting new patients
Shine Medical Providers PC Past Accepting new patients

Locations

308 S Friendswood Dr
Ste 110
Friendswood, TX 77546
Phone (281) 317-0094

12505 Memorial Dr
Ste 230
Houston, TX 77024
Phone (210) 858-9078

4242 Medical Dr
Ste 6300
San Antonio, TX 78229
Phone (210) 614-8400

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1053022186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 420151",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772420151",
            "telephone_number": "832-883-5156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12505 MEMORIAL DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770246051",
            "telephone_number": "832-883-5156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "ANGELA",
        "middle_name": "NJIDEKA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-09",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "65489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.