Matthew Hickman, RBT

Individual provider Active NPI Mental Health Counselor · Neptune Beach, FL

NPI 1144707753 · NPPES record last updated Jul 26, 2018

Key facts

NPI
1144707753
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
804 3Rd St Suite Ab
Neptune Beach, FL 32266
Phone
(904) 701-2926
NPI assigned
Jul 26, 2018
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RBT-18-61519FLMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-18-61519 FL
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

804 3Rd St Suite Ab
Neptune Beach, FL 32266

Mailing address

2111 Fordham Cir N
Jacksonville, FL 32217-9121
Phone (912) 667-9007

Other providers in Neptune Beach, FL

All providers in Neptune Beach, FL · Mental Health Counselor in Florida

Sources for this page

Verify at the official NPI Registry.