Individual provider Active NPI

Jennifer Barbara Hicks, MA

  • Mental Health Counselor
  • Dedham, MA
National Provider Identifier
1801403134
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
20 Eastbrook Rd Ste 104
Dedham, MA 02026-2088
Phone
(781) 329-9365
Fax
(781) 302-4635
NPI assigned
Sep 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

20 Eastbrook Rd Ste 104
Dedham, MA 02026-2088

Mailing address

20 Eastbrook Rd Ste 104
Dedham, MA 02026-2088
Phone (781) 302-4761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20240801003952 MA Practitioner - Mental Health Counselor 9931646460 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Toward Independent Living and Learning CurrentSince Jul 24, 2024 Accepting new patients
Toward Independent Living & Learning, Inc. CurrentSince Jul 24, 2024 Accepting new patients
South Shore Mental Health Center, Inc. CurrentSince Jul 15, 2025 Accepting new patients

Locations

1501 Washington St
Braintree, MA 02184
Phone (617) 745-2709

20 Eastbrook Rd
Ste 104
Dedham, MA 02026
Phone (781) 329-9365

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1801403134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 EASTBROOK RD STE 104",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020262088",
            "telephone_number": "781-302-4761",
            "fax_number": "781-302-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 EASTBROOK RD STE 104",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020262088",
            "telephone_number": "781-329-9365",
            "fax_number": "781-302-4635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "JENNIFER",
        "middle_name": "BARBARA",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-30",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dedham, MA

Sources for this page

Verify at the official NPI Registry.