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Provider Information for 1295448264


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JANICE LOUISE RICKS LCSW-S & LISW-S


Sex: Female

NPI: 1295448264
Last Updated: 2023-01-04
Certification Date: 2023-01-04

Details

NameValue
NPI1295448264
Enumeration Date2023-01-04
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 181 E LAKEVIEW ST
UMATILLA, FL 32784-9588
United States

Phone: 407-489-2860 | Fax:
 
Primary Practice Address 181 E LAKEVIEW ST
UMATILLA, FL 32784-9588
United States

Phone: 407-489-2860 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 1041C0700X - Social Worker - ClinicalOHi0600028
Yes 1041C0700X - Social Worker - ClinicalFLSW6816