Provider Demographics
NPI:1730977869
Name:HICKS, KATLYN SARAH (LCSW)
Entity type:Individual
Prefix:MISS
First Name:KATLYN
Middle Name:SARAH
Last Name:HICKS
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 1:1177 E LLOYD ST APT 103
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-6002
Mailing Address - Country:US
Mailing Address - Phone:850-313-2191
Mailing Address - Fax:
Practice Address - Street 1:1800 SAINT MARY AVE STE C
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-1096
Practice Address - Country:US
Practice Address - Phone:850-806-0545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW214441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical