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NPI Code Detail

MEDICARE: ROBYN L RICKERT M.S., L.P.C.

MEDICARE: ROBYN L RICKERT M.S., L.P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor2975125WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013003953
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBYN L RICKERT M.S., L.P.C.
Provider Business Mailing Address
First Line : 130 E WALNUT ST STE 406
Second Line : P.O. BOX 1108
City : GREEN BAY
State : WI
Zip : 54301-4231
Country : US
Telephone Number : 920-884-1187
Fax Number : 920-227-4100
Provider Business Practice Location Address
First Line : 130 E WALNUT ST
Second Line : SUITE 406
City : GREEN BAY
State : WI
Zip : 54301-4239
Country : US
Telephone Number : 920-884-1187
Fax Number : 920-227-4100
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 02/25/2008

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