Andrew Richard Hickam III, LPC, LPA
Individual provider Active NPI Mental Health Counselor · Big Spring, TX
NPI 1851469860 · NPPES record last updated Feb 20, 2012
Key facts
- NPI
- 1851469860
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- LPC 16145 (TX)
- Practice address
- 500 Johnson St
Big Spring, TX 79720-2644 - Phone
- (432) 263-3868
- Fax
- (432) 263-3402
- NPI assigned
- Nov 30, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPA 15197 | TX | MD | Mental Health Counselor |
| LPC 16145 | TX | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC 16145 | TX | Yes |
| Mental Health Counselor | 101YM0800X | LPA 15197 | TX |
Addresses
Primary practice location
500 Johnson St
Big Spring, TX 79720-2644
Mailing address
PO Box 1932
Big Spring, TX 79721-1932
Phone (432) 263-3868
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4163LC | Other | TX | BLUE CROSS BLUE SHIELD |
| 0959942-02 | Medicaid | TX |
Other providers in Big Spring, TX
- Health and Human Services Commission
- Susan R Henderson
- Chantanel Hendricks
- Donna Gayle Hernandez
- Joanna Hernandez
- William Paul Hillger
- Kayla Holguin
- Ruth Elizabeth Hook
- Shaila C. Hossain
- Howard County
All providers in Big Spring, TX · Mental Health Counselor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.