Provider Demographics
NPI:1174981948
Name:AUNJULI A. HICKS LPC LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:AUNJULI A. HICKS LPC LIMITED LIABILITY COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AUNJULI
Authorized Official - Middle Name:
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:908-364-7611
Mailing Address - Street 1:2130 MILLBURN AVE
Mailing Address - Street 2:STE C8
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-3725
Mailing Address - Country:US
Mailing Address - Phone:908-364-7611
Mailing Address - Fax:908-913-0912
Practice Address - Street 1:2130 MILLBURN AVE
Practice Address - Street 2:STE C8
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-3725
Practice Address - Country:US
Practice Address - Phone:908-364-7611
Practice Address - Fax:908-913-0912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-08
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00408800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1861743361OtherGROUP ID BCBS
NJ1225361157OtherNPI INDIVIDUAL