Active NPI
Lacy Hicks, LPC
- Counselor
- Pooler, GA
National Provider Identifier
1770029357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LPC008360
- Practice address
- 129 Kelly St
Pooler, GA 31322-2611 - Phone
- (912) 659-5866
- NPI assigned
- Jan 6, 2017
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | LPC008360 | GA | Primary |
Addresses
Primary practice location
129 Kelly St
Pooler, GA 31322-2611
Mailing address
129 Kelly St
Pooler, GA 31322-2611
Phone (912) 659-5866
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC008360 | GA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1483660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483660800000",
"number": "1770029357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "129 KELLY ST",
"city": "POOLER",
"state": "GA",
"postal_code": "313222611",
"telephone_number": "912-659-5866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "129 KELLY ST",
"city": "POOLER",
"state": "GA",
"postal_code": "313222611",
"telephone_number": "912-659-5866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKS",
"first_name": "LACY",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-06",
"last_updated": "2017-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "GA",
"license": "LPC008360",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pooler, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.