Jamie Hickman, MA

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LGP10322 Issued in MD

Practice address

124 Slade Ave Ste 101
Baltimore, MD 21208-4900

Phone

(443) 680-7931

NPI assigned

Mar 31, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bon Ridge Wellness LLCGroup PAC ID 1951775337, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Bon Ridge Wellness, LLC

  • Clinical Social Worker
  • Windsor Mill, MD
  • NPI 1922710995

  Counselor

  Medicare reassignment Care Compare group NPD
• Bon Ridge Wellness, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Windsor Mill, MD
  • NPI 1043004575
  NPD (past)

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1124656384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4103 CALLAWAY AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212156113",
            "telephone_number": "443-680-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 SLADE AVE STE 101",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212084900",
            "telephone_number": "443-680-7931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "JAMIE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-31",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP10322",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MD",
            "license": "LGP10322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brent Hickey, OTD, OTR/L
• Carl Ray Hickey, MS
• Kara Hickey, CNM
• Stephen Joseph Hickey, D.M.D.
• Danielle Hickman, LCPC
• Lauren Deanna Hickman, PHARMD
• Tiesha Lachelle Hicks-Miller
• Jami Hicks-Townes, CRNP-PMH
• Bryan Hicks, PA
• Caitlin Whitney Hicks, M.D., M.S.

• Counselor in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.