WALLACE KENT HICKS (NPI# 1356320212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356320212 |
| Entity Type | Individual |
| Full Name | WALLACE KENT HICKS |
| Credential | ED.D. |
| Practice Address |
7400 New La Grange Rd Ste 312 Louisville KY 40222-4870 |
| Practice Telephone | 5023949990 |
| Practice Fax Number | 5023949992 |
| Mailing Telephone | 5023949990 |
| Mailing Fax Number | 5023949992 |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2011-01-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
KY 0227 | KY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 89002273 | 05 | |
| KY | CIGNA BEHAVIORAL HEALTH | 1058075 | 01 |
| KY | CIGNA HEALTHCARE | 4716671 | 01 |
| KY | COMPSYCH | 179497 | 01 |
| KY | MAGELLAN | 461331000 | 01 |
| KY | VALUE OPTIONS | 009407 | 01 |
| KY | APS | 130222 | 01 |
| KY | UNITED BEHAVIORAL HEALTH | 6162200 | 01 |
| KY | ANTHEM | 000000342982 | 01 |
| KY | AETNA | 4139574 | 01 |
| KY | MHN | 93040 | 01 |
| Street Address |
7400 NEW LA GRANGE RD STE 312 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40222-4870 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629056080 | Carol B Peterson | Psychologist | 7400 New La Grange Rd, Ste 312, Louisville, KY 40222-4870 | 2006-01-05 |
| 1538430624 | Charles Biebel | Psychologist | 7400 New La Grange Rd, Suite 404, Louisville, KY 40222-4870 | 2012-01-20 |
| 1609193382 | Alan Ray Plappert | Social Worker | 7400 New La Grange Rd, Suite 315, Louisville, KY 40222-4870 | 2010-04-21 |
| 1871643049 | Sally Faith Digiovanni | Marriage & Family Therapist | 7400 New La Grange Rd, Suite 315, Louisville, KY 40222 | 2007-01-11 |
| 1114089810 | Lee Alan Coleman | Psychiatry & Neurology | 7400 New La Grange Rd, Suite 301, Louisville, KY 40222-4870 | 2006-12-16 |
| 1750360624 | Larry M. Raskin | Psychologist | 7400 New La Grange Rd, Ste 312, Louisville, KY 40222-4870 | 2006-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740881507 | Lucas Counseling and Consulting | Counselor | 8134 New Lagrange Road Suite 100, Louisville, KY 40222 | 2020-11-06 |
| 1700424157 | Hope4hearts Counseling LLC | Community/Behavioral Health | 7321 New Lagrange Road, Louisville, KY 40222 | 2019-12-17 |
| 1982162509 | Sydney Sleadd | Massage Therapist | 7505 New Lagrange Rd, Ste 101, Louisville, KY 40222 | 2019-03-04 |
| 1205390127 | Rebecca A Street | Marriage & Family Therapist | 8134 New La Grange Rd Ste 227, Louisville, KY 40222 | 2019-01-24 |
| 1689176166 | Andrew Pennington | Social Worker | 1015 Dorsey Ln., Louisville, KY 40222 | 2018-03-01 |
| 1578085957 | Megan Lusco | Case Manager/Care Coordinator | 312 Whittington Parkway, Suite 020, Louisville, KY 40222 | 2017-07-07 |
| 1083149868 | Kate Oliver Ray | Optometrist | 2420 Lime Kiln Ln Ste H, Louisville, KY 40222 | 2017-04-28 |
| 1578094736 | Jacqueline Ward | Speech-Language Pathologist | 910 Fenley Avenue, Louisville, KY 40222 | 2017-03-21 |
| 1295195907 | Carol Massey | Psychologist | 7400 Newlagrange Roed, 308, Louisville, KY 40222 | 2016-02-24 |
| 1588047260 | Melissa Cosby | Case Manager/Care Coordinator | 312 Whittington Parkway Suite 020, Louisville, KY 40222 | 2015-06-30 |
| Find all providers in zip 40222 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376013342 | Carmen Sue Frederick | Psychologist | 731 Speckman Road, Louisville, KY 40243 | 2018-12-03 |
| 1295195907 | Carol Massey | Psychologist | 7400 Newlagrange Roed, 308, Louisville, KY 40222 | 2016-02-24 |
| 1972962348 | Sara W Sutphin | Psychologist | 329 Plaza Ave, Louisville, KY 40218-3411 | 2016-02-15 |
| 1457732331 | Norah Slone | Psychologist | 8130 Coppercreek Dr, Louisville, KY 40222-6812 | 2015-06-16 |
| 1326396730 | Eugene Howard Foster | Psychologist | 13502 Cypress Springs Ct, Louisville, KY 40245-7403 | 2012-08-16 |
| 1477870079 | Danelle Stevens-watkins Phd Pllc | Psychologist | 6511 Glenridge Park Place Ste 5, Louisville, KY 40222-3452 | 2010-04-23 |
| 1457501413 | Amanda Christine Voils-levenda | Psychologist | 1911 Bardstown Rd, Suite #bl, Louisville, KY 40205 | 2008-09-26 |
| 1285837435 | G. Stephen Perry | Psychologist | 3103 Breckenridge Ln Ste 5, Louisville, KY 40220-5730 | 2007-06-06 |
| 1306055512 | Brenda F. Nash | Psychologist | 133 N Evergreen Rd Ste 206, Louisville, KY 40243-1484 | 2007-05-22 |
| 1386711059 | Health Counseling & Educational Services Inc | Psychologist | 1412 Blue Vale Way, Louisville, KY 40222-3806 | 2006-11-29 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40222 |
Please comment or provide details below to improve the information on WALLACE KENT HICKS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.