Sue Hicks LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

SUE HICKS LLC

Practice address

4477 W Emerald St Ste C275
Boise, ID 83706-2078

Phone

(208) 740-0391

NPI assigned

Feb 2, 2021

Organization subpart

No

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

Authorized official

Name

Sue M Hicks, LCSWNPI 1023028990

Title

Owner

Phone

(208) 740-0391

Specialties & licenses 1

Addresses

Other names 1

• Boise VA Medical Center Other name

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sue Marie Hicks, LCSW, CADC III

  • Addiction (Substance Use Disorder) Counselor
  • Boise, ID
  • NPI 1023028990
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612224000000",
    "number": "1124619978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5524 S CAPER PL",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837166929",
            "telephone_number": "208-740-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4477 W EMERALD ST STE C275",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837062078",
            "telephone_number": "208-740-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUE HICKS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-02",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "SUE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-740-0391",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boise VA Medical Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• C. Manuel Suarez, M.D.
• Nora M Suarez, NP
• Shalee Sucher
• Leah Marie Suddarth, LCPC
• Katie Sudhalter, LPC
• Michelle Marie Sugden, PHARMD
• Cheryl Suhr, NP
• Jennifer L Suida, CRNP
• Michael Joseph Suida, CRNA
• C Eugene Sullivan, M.D.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Boise, ID
• Providers in Boise, ID by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.