Active NPI
Taci Hicks, LCSW
- Clinical Social Worker
- Raytown, MO
National Provider Identifier
1689360190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2024014876
- Practice address
- 7001 Blue Ridge Blvd
Raytown, MO 64133-5629 - Phone
- (816) 988-2739
- NPI assigned
- Apr 17, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2024014876 | MO | Primary |
Addresses
Primary practice location
7001 Blue Ridge Blvd
Raytown, MO 64133-5629
Mailing address
1555 NE Rice Rd
Lees Summit, MO 64086-5849
Phone (816) 347-3069
Other practice location 1
12902 S Outer Belt Rd
Lone Jack, MO 64070-8538
Phone (816) 820-5451
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2024 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2024014876 | MO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716336000000",
"number": "1689360190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1555 NE RICE RD",
"city": "LEES SUMMIT",
"state": "MO",
"postal_code": "640865849",
"telephone_number": "816-347-3069",
"fax_number": "816-347-3200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7001 BLUE RIDGE BLVD",
"city": "RAYTOWN",
"state": "MO",
"postal_code": "641335629",
"telephone_number": "816-988-2739"
}
],
"practiceLocations": [
{
"address_1": "12902 S Outer Belt Rd",
"address_purpose": "LOCATION",
"city": "Lone Jack",
"state": "MO",
"postal_code": "640708538",
"country_code": "US",
"telephone_number": "816-820-5451",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HICKS",
"first_name": "TACI",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-17",
"last_updated": "2024-05-22",
"certification_date": "2024-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2024014876",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raytown, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.