Michelle M. Hicks

Individual provider Active NPI Professional Counselor · Emporia, VA

NPI 1477228641 · NPPES record last updated Aug 10, 2021

Key facts

NPI
1477228641
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
0701010574 (VA)
Practice address
978 Fish Rd
Emporia, VA 23847-5031
Phone
(434) 378-2279
NPI assigned
Aug 10, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0701010574VAMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor
Group: 193400000X SINGLE SPECIALTY GROUP
101YP2500X 0701010574 VA Yes

Addresses

Primary practice location

978 Fish Rd
Emporia, VA 23847-5031

Mailing address

978 Fish Rd
Emporia, VA 23847-5031

Other providers in Emporia, VA

All providers in Emporia, VA · Professional Counselor in Virginia

Sources for this page

Verify at the official NPI Registry.