Kendall Raye Hickson

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

16-05-22

Practice address

687 Cheshire Ave
Eugene, OR 97402-5060

Phone

(541) 684-4172

Fax

(541) 684-4156

NPI assigned

Jul 19, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1374192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1306288246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "687 CHESHIRE AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974025060",
            "telephone_number": "541-762-4556",
            "fax_number": "541-684-4156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "687 CHESHIRE AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974025060",
            "telephone_number": "541-684-4172",
            "fax_number": "541-684-4156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKSON",
        "first_name": "KENDALL",
        "middle_name": "RAYE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-19",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": "16-05-22",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500661497",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Louis Hicks, PH.D.
• Natalia Ivanivna Hicks
• Rebecca Rae Hicks
• Amy Hickson, OTR/L, CLT
• Kellie Hickson
• Joshua Higashi
• Shayna-Ann Higashi
• Johanna Lyn Higdon, MD
• Kara Nicole Higgason
• Ashley Higgins

• Addiction (Substance Use Disorder) Counselor in Eugene, OR
• Providers in Eugene, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.