Individual provider Active NPI

Jacquelyn Suzanne Hicks

  • Mental Health Counselor
  • Mason, MI
National Provider Identifier
1447860689
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401223031 Issued in MI
Practice address
351 Coventry LN
Mason, MI 48854-1162
Phone
(517) 604-8083
NPI assigned
Aug 3, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6401223031 MI Primary
Counselor 101Y00000X 6401223031 MI

Addresses

Primary practice location

351 Coventry LN
Mason, MI 48854-1162

Mailing address

351 Coventry LN
Mason, MI 48854-1162
Phone (517) 604-8083

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20240213001038 MI Practitioner - Mental Health Counselor 8224471644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

351 Coventry LN
Mason, MI 48854-1162
Phone (517) 604-8083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jacqui Hicks Connective Healings PLLC Counselor CurrentSince Jan 1, 2024 Accepting new patients
CJT Solutions Professional CurrentSince Nov 8, 2020 Accepting new patients
Oakland Psychological Clinic, P.C. Mental Health CurrentSince Jan 26, 2022 Accepting new patients
Jonathan M. Blair PHD, PLLC PastSince Aug 1, 2020 Accepting new patients

Locations

5123 W St Joe Hwy
Ste 103
Lansing, MI 48917
Phone (517) 323-4099

120 N Washington Sq
Ste 300
Lansing, MI 48933
Phone (317) 510-0758

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1447860689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 COVENTRY LN",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488541162",
            "telephone_number": "517-604-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 COVENTRY LN",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488541162",
            "telephone_number": "517-604-8083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "JACQUELYN",
        "middle_name": "SUZANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-03",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401223031",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401223031",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, MI

Sources for this page

Verify at the official NPI Registry.