Telisa Michelle Hickson, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

17375 Issued in MD

Practice address

7601 Bluff Point LN
Elkridge, MD 21075-7918

Phone

(301) 801-9675

Fax

(240) 804-9722

NPI assigned

Sep 13, 2018

Last updated

Jul 26, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Safe Harbor Behavioral Care LLCGroup PAC ID 0345514675, 81 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Safe Harbor Behavioral Care, LLC

  • Clinical Social Worker
  • Bel Air, MD
  • NPI 1316487879
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1700369956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 BLUFF POINT LN",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210757918",
            "telephone_number": "301-801-9675",
            "fax_number": "240-804-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 BLUFF POINT LN",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210757918",
            "telephone_number": "301-801-9675",
            "fax_number": "240-804-9722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKSON",
        "first_name": "TELISA",
        "middle_name": "MICHELLE",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "17375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devin Alexandra Heilmeier
• Jasmine Alecia Henderson, APRN
• Tamica Monique Henry
• Elizabeth Ann Herdson, MS, OTR/L
• Hermes Mobility LLC
• Hightower Care LLC
• Cheree Monique Hill, RN
• Jade Hill
• Andrew A Hinton, DPT
• Jack Hofmeister

• Clinical Social Worker in Elkridge, MD
• Providers in Elkridge, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.