Individual provider Active NPI

Richard Ernest Hicks, PH.D.

  • Clinical Psychologist
  • Raleigh, NC
National Provider Identifier
1740395987
Registry record updated Oct 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP-3411 Issued in NC
Practice address
4201 Lake Boone TRL
Raleigh, NC 27607-7512
Phone
(919) 961-1095
NPI assigned
Aug 20, 2006
Last updated
Oct 4, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2013

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP-3411 NC
Addiction (Substance Use Disorder) Psychologist 103TA0400X LP-3411 NC
Adult Development & Aging Psychologist 103TA0700X LP-3411 NC
Cognitive & Behavioral Psychologist 103TB0200X LP-3411 NC
Clinical Psychologist 103TC0700X LP-3411 NC Primary
Clinical Child & Adolescent Psychologist 103TC2200X LP-3411 NC
Family Psychologist 103TF0000X LP-3411 NC
Health Service Psychologist 103TH0100X 3411 NC
Group Psychotherapy Psychologist 103TP2701X LP-3411 NC
Health Psychologist 103TH0004X 3411 NC

Addresses

Primary practice location

4201 Lake Boone TRL
Raleigh, NC 27607-7512

Mailing address

117 W Park Dr
Raleigh, NC 27605-1737
Phone (919) 961-1095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20160223001145 NC Practitioner - Clinical Psychologist 7113222597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
HRC Behavioral Health and Psychiatry, PAGroup PAC ID 9436044765, 5 clinicians

Practice addresses (Care Compare)

100 Europa Dr
Suite 260
Chapel Hill, NC 27517-2394
Phone (919) 929-1227

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LP-3411NCMDAddiction (Substance Use Disorder) Psychologist
3411NCMDHealth Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
HRC Behavioral Health & Psychiatry, PA Psychologist CurrentSince Jan 1, 2016 Accepting new patients

Locations

100 Europa Dr
Ste 260
Chapel Hill, NC 27517
Phone (919) 929-1227

4201 Lake Boone Trl
Ste 201
Raleigh, NC 27607
Phone (919) 442-1123

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16901/brand/1/csg/1/fhir/r4
  • Direct secure messaging: richard.hicks.1@16901.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380844800000",
    "number": "1740395987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W PARK DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276051737",
            "telephone_number": "919-961-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 LAKE BOONE TRL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077512",
            "telephone_number": "919-961-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "RICHARD",
        "middle_name": "ERNEST",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2013-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "LP-3411",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LP-3411",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NC",
            "license": "LP-3411",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NC",
            "license": "LP-3411",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "LP-3411",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NC",
            "license": "LP-3411",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "NC",
            "license": "LP-3411",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "NC",
            "license": "3411",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NC",
            "license": "LP-3411",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "NC",
            "license": "3411",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.