Alex Michael Hickinbotham, CDCA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

141590 Issued in OH

Practice address

680 Park Ave W
Mansfield, OH 44906-3706

Phone

(419) 528-5993

NPI assigned

Mar 16, 2017

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1790226264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "876 ARLINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449037020",
            "telephone_number": "419-632-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 PARK AVE W",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449063706",
            "telephone_number": "419-528-5993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKINBOTHAM",
        "first_name": "ALEX",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "CDCA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-16",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "141590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rogerlynn Hess
• Ruby J Hess
• Erica Nicole Hesselden
• Randall E Hester, DDS
• HHCS, Inc.
• Kelsey Brianne Hickman, PHARMD
• Alisha Hicks
• Kathy L Hicks, LMT
• Alanna Dawn Higgins, LMT
• Baylee Higgins

• Addiction (Substance Use Disorder) Counselor in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.

Verify at the official NPI Registry.