Individual provider Active NPI

Judith Mary Hickey, MSW LCSW

  • Clinical Social Worker
  • Milwaukee, WI
National Provider Identifier
1891968962
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1625 123 Issued in WI
Practice address
4757 N 76TH St
Milwaukee, WI 53218-4732
Phone
(414) 358-4167
Fax
(414) 358-5005
NPI assigned
Apr 9, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1625 123 WI Primary

Addresses

Primary practice location

4757 N 76TH St
Milwaukee, WI 53218-4732

Mailing address

4757 N 76TH St
Milwaukee, WI 53218-4732
Phone (414) 358-4167

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

LicenseStateTypeSpecialty
1625 123WIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1891968962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4757 N 76TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532184732",
            "telephone_number": "414-358-4167",
            "fax_number": "414-358-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4757 N 76TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532184732",
            "telephone_number": "414-358-4167",
            "fax_number": "414-358-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKEY",
        "first_name": "JUDITH",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "MSW LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-09",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "1625 123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; 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.