Kimberly Hicks, MA is a medicare enrolled "Counselor - Professional" provider in Holden, Maine. Her current practice location is
31 Dragonfly Dr, Holden, Maine. You can reach out to her office (for appointments etc.) via phone at
(970) 658-9716.
Kimberly Hicks is licensed to practice in Colorado (license number LPC.0013314) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1780089854.
Healthcare Provider's Profile
| Full Name | Kimberly Hicks |
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| Gender | Female |
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| Speciality | Counselor - Professional |
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| Location | 31 Dragonfly Dr, Holden, Maine |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1780089854
- Provider Enumeration Date: 10/30/2014
- Last Update Date: 03/06/2025
Medicare PECOS Information:
- PECOS PAC ID: 0840642351
- Enrollment ID: I20240120000337
Medical Identifiers
Medical identifiers for Kimberly Hicks such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1780089854 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YP2500X | Counselor - Professional | LPC.0013314 (Colorado) | Primary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | CC7790 (Maine) | Secondary |
| 101YP2500X | Counselor - Professional | 10007 (South Carolina) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kimberly Hicks allows following entities to bill medicare on her behalf.
| Entity Name | Poudre Valley Medical Group Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1225356868
PECOS PAC ID: 9638208549
Enrollment ID: O20100602000122 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kimberly Hicks is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kimberly Hicks, MA
31 Dragonfly Dr,
Holden, ME 04429-7558
Ph: (970) 658-9716 | Kimberly Hicks, MA
31 Dragonfly Dr,
Holden, ME 04429-7558
Ph: (970) 658-9716 |
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