Jessica Joy Hicks, BCBA
Individual provider Active NPI Behavior Analyst · Gray, TN
NPI 1215075916 · NPPES record last updated Oct 11, 2024
Key facts
- NPI
- 1215075916
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 0133001839 (VA)
- Practice address
- 182 Maden Dr
Gray, TN 37615-2212 - Phone
- (423) 483-7005
- Fax
- (423) 220-8231
- NPI assigned
- Feb 2, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0133001839 | VA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Little Blessings ABA, PLLC | Behavior Analyst | Current |
Accepting new patients |
| Common Thread ABA LLC | Behavior Analyst | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 0133001839 | VA | Yes |
Addresses
Primary practice location
182 Maden Dr
Gray, TN 37615-2212
Mailing address
182 Maden Dr
Gray, TN 37615-2212
Phone (423) 483-7005
Other providers in Gray, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.