Andrew Hickman

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

278286 Issued in KY

Practice address

633 Baxter Ave
Louisville, KY 40204-1157

Phone

(502) 309-2408

NPI assigned

May 3, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  KY

  Medicare reassignment NPD
• Transcendence Forge, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Louisville, KY
  • NPI 1710730767
  NPD Authorized official
• Brightside Medical, P.C.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1801355482
  NPD (past)

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

{
    "created_epoch": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1346939675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 S MAIN ST",
            "city": "EMINENCE",
            "state": "KY",
            "postal_code": "400191127",
            "telephone_number": "775-771-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 BAXTER AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402041157",
            "telephone_number": "502-309-2408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-03",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "278286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Joan Hickerson
• Adriene Alisa Hickerson
• Emily Elaine Hickerson, NP
• Michelle Marie Hickey, MOT, OTR
• Ruby Lee Hicklin, RD LD
• April M Hickman
• Naklisha Hickman
• Pammie Hickman
• Taft Van Hickman
• Hicks Enterprises

• Clinical Psychologist in Louisville, KY
• Providers in Louisville, KY by specialty
• Clinical Psychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.