| Mr Timothy Michael Hicks, PCC | |
|
2801 C Ct, Ashtabula, OH 44004-4577 | |
| (440) 998-4210 | |
| (440) 998-6775 |
| Full Name | Mr Timothy Michael Hicks |
|---|---|
| Gender | Male |
| Speciality | Mental Health Counselor |
| Experience | 22 Years |
| Location | 2801 C Ct, Ashtabula, Ohio |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831280619 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | E.0008268 (Ohio) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ravenwood Mental Health Center | 6901813922 | 57 |
| Entity Name | Ravenwood Mental Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730356296 PECOS PAC ID: 6901813922 Enrollment ID: O20060316000394 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Timothy Michael Hicks, PCC 2801 C Ct, Ashtabula, OH 44004-4577 Ph: (440) 998-4210 | Mr Timothy Michael Hicks, PCC 2801 C Ct, Ashtabula, OH 44004-4577 Ph: (440) 998-4210 |
Karen Fronczak, Counselor Medicare: Medicare Enrolled Practice Location: 2801 C Ct, Ashtabula, OH 44004 Phone: 440-998-4210 Fax: 440-998-2247 |
Kayla Frye, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2801 C Ct, Ashtabula, OH 44004 Phone: 440-998-0722 |
Jason Robert Carmody, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2210 S Ridge Rd E, Ashtabula, OH 44004 Phone: 513-834-7063 |
Haylee Mcmahon, CDCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 2801 C Ct, Ashtabula, OH 44004 Phone: 440-998-4210 |
Cali Faye Marie Richardson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2801 C Ct, Ashtabula, OH 44004 Phone: 440-998-4210 |
Christopher Cope, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3418 Lake Ave, Ashtabula, OH 44004 Phone: 440-650-5030 |
Carlen Pittman, CDCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 3418 Lake Ave, Ashtabula, OH 44004 Phone: 440-650-5030 |