Brenetta Hicks-Jones

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

BH-3839 Issued in AZ

Practice address

1318 S Coati Dr
Tucson, AZ 85713-1218

Phone

(520) 623-1022

NPI assigned

Nov 17, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: hicksjones.devereux.p1@direct.codachrw.nextgenshare.com

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.

• The Devereux Foundation

  • Adolescent and Children Mental Health Clinic/Center
  • Phoenix, AZ
  • NPI 1306939368
  NPD (past)

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

{
    "created_epoch": "1321488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1881961969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 S COATI DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857131218",
            "telephone_number": "520-623-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 S COATI DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857131218",
            "telephone_number": "520-623-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS-JONES",
        "first_name": "BRENETTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-17",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH-3839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ DEPT OF HEALTH SERVICES",
            "identifier": "BH-3938",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meredith Megan Hickerson
• Idalia Berenice Hickey, BA
• Terrence Hickey, MS
• Trennon Hickey, COTA
• Maria Carmen Hickle
• Austyn Hicks
• Cassandra Ann Hicks, PH.D.
• Katherine Valentine Hicks, D.D.S.
• Morris A Hicks, DDS
• Rina Hicks

• Mental Illness Community Based Residential Treatment Facility in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Mental Illness Community Based Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; 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.