Carron Ickes, LSW, CDCA

Primary specialty

Social WorkerTaxonomy code 104100000X

License

1440286 Issued in OH

Practice address

897 E Iron Ave
Dover, OH 44622-2030

Phone

(330) 343-5555

NPI assigned

Nov 26, 2014

Last updated

Nov 26, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1416960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416960000000",
    "number": "1902203581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "897 E IRON AVE",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446222030",
            "telephone_number": "330-343-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "897 E IRON AVE",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446222030",
            "telephone_number": "330-343-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICKES",
        "first_name": "CARRON",
        "credential": "LSW, CDCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-26",
        "last_updated": "2014-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "060327",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "1440286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Hunt
• Barbara Hunter
• Miranda Hupp
• Jennifer L Hursey-Avon, LPC, LSW
• Lacy Iberis
• Nicholas Scott Immel, DPT
• Anthony Joseph Incarnato Sr., M.A.
• Internal Medicine Clinic, LTD
• Michele Gabriello Ionno, DPT, MS
• Kaylie Irwin

• Social Worker in Dover, OH
• Providers in Dover, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2014; 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.