Provider Demographics
NPI:1083508469
Name:HICKEY, CAROLINE MCGANN
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:MCGANN
Last Name:HICKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1937 N DAYTON ST UNIT G
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-0591
Mailing Address - Country:US
Mailing Address - Phone:312-210-0011
Mailing Address - Fax:
Practice Address - Street 1:1811 W NORTH AVE STE 402
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-0204
Practice Address - Country:US
Practice Address - Phone:312-819-7381
Practice Address - Fax:312-428-3093
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor