Jewell Patricia Hickman, LPC

Individual provider Active NPI Professional Counselor · Saint Ann, MO

NPI 1487628491 · NPPES record last updated Jul 13, 2026

Key facts

NPI
1487628491
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
2002010842 (MO)
Practice address
11138 Old Saint Charles Rd
Saint Ann, MO 63074-2113
Phone
(314) 344-0983
Fax
(314) 344-0983
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
No

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
2002010842MOMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2002010842 MO
Professional Counselor 101YP2500X 2002010842 MO Yes

Addresses

Primary practice location

11138 Old Saint Charles Rd
Saint Ann, MO 63074-2113

Mailing address

9800 Edgefield Dr
Saint Louis, MO 63136-5419
Phone (314) 503-2696

Other providers in Saint Ann, MO

All providers in Saint Ann, MO · Professional Counselor in Missouri

Sources for this page

Verify at the official NPI Registry.