Provider Demographics
NPI:1487237756
Name:HOSICK, BRITNI JORDAN (LCSW)
Entity type:Individual
Prefix:
First Name:BRITNI
Middle Name:JORDAN
Last Name:HOSICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:IL
Mailing Address - Zip Code:62471-2237
Mailing Address - Country:US
Mailing Address - Phone:405-831-6437
Mailing Address - Fax:
Practice Address - Street 1:320 N 6TH ST
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:IL
Practice Address - Zip Code:62471-2237
Practice Address - Country:US
Practice Address - Phone:405-831-6437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0228991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical