Andrew G Hicks, MS, MA, LLP, CADC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6361008171 Issued in MI

Practice address

PO Box 175
West Olive, MI 49460-0175

Phone

(231) 215-8976

NPI assigned

Dec 21, 2019

Last updated

May 19, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts, Master of Science

State licenses

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

{
    "created_epoch": "1576886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1457990400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 175",
            "city": "WEST OLIVE",
            "state": "MI",
            "postal_code": "494600175",
            "telephone_number": "231-215-8976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 175",
            "city": "WEST OLIVE",
            "state": "MI",
            "postal_code": "494600175",
            "telephone_number": "231-215-8976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "ANDREW",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "MS, MA, LLP, CADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-21",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "02-1292",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6361008171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN CERTIFICATION BOARD FOR ADDICTION PROFESSIONALS",
            "identifier": "12-0292",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN",
            "identifier": "6361008171",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sean M Cunningham, DO
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• Melanie Bernice Homik
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• Jay Emerson Kellaway, M.D.
• Laura Ann Koster, RN

• Psychologist in West Olive, MI
• Providers in West Olive, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; 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.