| Bethany Jo Hicks, LCSW | |
|
651 Kauhikoa Rd, Haiku, HI 96708-4805 | |
| (970) 214-7735 | |
| Not Available |
| Full Name | Bethany Jo Hicks |
|---|---|
| Gender | Female |
| Speciality | Clinical Social Worker |
| Experience | 12 Years |
| Location | 651 Kauhikoa Rd, Haiku, Hawaii |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598319675 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW-4420 (Hawaii) | Secondary |
| 1041C0700X | Social Worker - Clinical | LCSW.9924978 (Colorado) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sondermind Provider Network Llc | 9537572490 | 874 |
| Sondermind Provider Network Llc | 9537572490 | 874 |
| Entity Name | Kaiser Foundation Health Plan Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063515567 PECOS PAC ID: 1850205360 Enrollment ID: O20031119000948 |
| Entity Name | Sondermind Provider Network Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760854442 PECOS PAC ID: 9537572490 Enrollment ID: O20240613001122 |
| Mailing Address | Practice Location Address |
|---|---|
| Bethany Jo Hicks, LCSW Po Box 331371, Kahului, HI 96733-1371 Ph: (970) 214-7735 | Bethany Jo Hicks, LCSW 651 Kauhikoa Rd, Haiku, HI 96708-4805 Ph: (970) 214-7735 |
Desiree Henry, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1164 W Kuiaha Rd, Haiku, HI 96708 Phone: 860-964-8692 | |
Marilou Penner, MSW LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1111 Kaupakalua Rd, Haiku, HI 96708 Phone: 808-269-7411 | |
Mr. Michael A Dattola, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1090 E Kuiaha Rd, Haiku, HI 96708 Phone: 808-707-7219 Fax: 808-649-2229 | |
Mr. Paul David Solomon, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: Po Box 1183, Haiku, HI 96708 Phone: 808-633-3009 |