Provider Demographics
NPI:1255117511
Name:KICKER, BRITTANY MARIE (LMSW)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MARIE
Last Name:KICKER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4227 ARBORETUM DR
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-3875
Mailing Address - Country:US
Mailing Address - Phone:719-231-9866
Mailing Address - Fax:
Practice Address - Street 1:2200 SPACE PARK DR STE 240
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3881
Practice Address - Country:US
Practice Address - Phone:832-582-4164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-04
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67478104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker