Sabrina R Hickerson

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

30 NE Martin Luther King Jr Blvd
Portland, OR 97232-2941

Phone

(503) 232-1099

NPI assigned

Feb 23, 2022

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Telecare Mental Health Services of Oregon, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Portland, OR
  • NPI 1124310305
  NPD (past)

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1457007981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 NE MARTIN LUTHER KING JR BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322941",
            "telephone_number": "503-232-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 NE MARTIN LUTHER KING JR BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322941",
            "telephone_number": "503-232-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKERSON",
        "first_name": "SABRINA",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-23",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Hibler
• Donald Joseph Hice, QMHP
• David Howard Hickam, M.D.
• Michael William Hickel, D.C.
• Alan Hickenbottom
• Alexander Robert Hickey
• Eric Harris Hickey
• Jessica Marie Hickey
• Judy B Hickey, CADC I/QMHA-R
• Kaelyn Hickey

• Specialist in Portland, OR
• Providers in Portland, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; 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.