Blair Haren Hickman, MSSW LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LSW3260 Issued in TN

Practice address

926 W Oakland Ave
Suite 226
Johnson City, TN 37604-1445

Phone

(423) 262-0317

Fax

(423) 262-0311

NPI assigned

Sep 11, 2006

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 5

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Tri-Star Counseling, LLC

  • Clinical Social Worker
  • Kingsport, TN
  • NPI 1184376741
  NPD (past)

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281571200000",
    "number": "1992809909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 W OAKLAND AVE",
            "address_2": "SUITE 226",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376041445",
            "telephone_number": "423-262-0317",
            "fax_number": "423-262-0311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 W OAKLAND AVE",
            "address_2": "SUITE 226",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376041445",
            "telephone_number": "423-262-0317",
            "fax_number": "423-262-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "BLAIR",
        "middle_name": "HAREN",
        "credential": "MSSW  LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-11",
        "last_updated": "2010-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TN",
            "license": "LSW3260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA-MCC",
            "identifier": "1047231",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH-HEALTHPLAN",
            "identifier": "100676",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE-TN",
            "identifier": "3697987",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN SUMMIT",
            "identifier": "3085266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL WORKERS COMP",
            "identifier": "351654200",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Eric Hershman, M.D.
• Lori Hess, MS CCC-SLP
• Rick Hess, PHARMD, BC-ADM, CDE
• Andrea Nicole Hetherington, FNPC
• Jackson Hetzler, PHARMD
• Lacy Hicks, CPNP
• Melanie R Hicks, LPC
• Angela D Higgins, P.T.
• Kirsten Higgins, MS, LPC/MHSP
• Highland Springs Medical PC

• Social Worker in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.