Active NPI
Susan Correll Hickerson, LPC, LPCS, LCAS
- Professional Counselor
- Weaverville, NC
National Provider Identifier
1316106768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4269
- Practice address
- 58 David Biddle TRL
Weaverville, NC 28787-9736 - Phone
- (828) 658-0561
- NPI assigned
- Jun 2, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 4269 | NC | |
| Professional Counselor | 101YP2500X | 4269 | NC | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 20689 | NC | |
| Counselor | 101Y00000X | 4269 | NC |
Addresses
Primary practice location
58 David Biddle TRL
Weaverville, NC 28787-9736
Mailing address
58 David Biddle TRL
Weaverville, NC 28787-9736
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12345678 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20689 | NC | MD | Pharmacist |
| 4269 | NC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555372800000",
"number": "1316106768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "58 DAVID BIDDLE TRL",
"city": "WEAVERVILLE",
"state": "NC",
"postal_code": "287879736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "58 DAVID BIDDLE TRL",
"city": "WEAVERVILLE",
"state": "NC",
"postal_code": "287879736",
"telephone_number": "828-658-0561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKERSON",
"first_name": "SUSAN",
"middle_name": "CORRELL",
"credential": "LPC, LPCS, LCAS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-02",
"last_updated": "2019-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "4269",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "4269",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "20689",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NC",
"license": "4269",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "12345678",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Weaverville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.