John Vicent Hickman, LCSW, CASAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R045978 Issued in NY

Practice address

15 Horseblock PL
Farmingville, NY 11738-1204

Phone

(631) 854-2571

Fax

(631) 854-2550

NPI assigned

Nov 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538230495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 BEECH ST",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117553141",
            "telephone_number": "631-981-2843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 HORSEBLOCK PL",
            "city": "FARMINGVILLE",
            "state": "NY",
            "postal_code": "117381204",
            "telephone_number": "631-854-2571",
            "fax_number": "631-854-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "JOHN",
        "middle_name": "VICENT",
        "name_prefix": "Mr.",
        "credential": "LCSW, CASAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R045978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00354807",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa M Guiliano, M.S.
• Lauren Gustaferri
• Lauren Guzman, RN
• Rosalind Haff, RN
• Dena S Hanna, DDS
• Isiah Hinson
• Jeanine Hintze
• Sharon Hoey, PA
• Joanne Holmes, LCSW
• Nicole Marie Horak, MSED

• Clinical Social Worker in Farmingville, NY
• Providers in Farmingville, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.