Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Jeremiah Wayne Hicks, LCSW, CAADC, CCDPD

Individual provider Clinical Social Worker · NPI 1477890382

Mr. Jeremiah Wayne Hicks, LCSW, CAADC, CCDPD is a Clinical Social Worker in State College, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2013.

Licensed in
PA
In the registry since
2013
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

1993 Cato Ave
State College, PA 16801-2754
Phone: (814) 231-8820
Fax: (814) 231-8857
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence CW017437 (PA)

Record details

NPI number1477890382
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW , CAADC , CCDPD
Sole proprietorNo
NPI enumeratedJanuary 11, 2013
Last updated in NPPESOctober 18, 2017

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