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NPI Code Detail

MEDICARE: KARREN BOONE RICKS LCSW

MEDICARE:   KARREN BOONE RICKS  LCSW
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
11041C0700XClinical Social WorkerC005061NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
214113OTHERNCBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1639244023
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARREN BOONE RICKS LCSW
Provider Business Mailing Address
First Line : 406 N CHURCH ST
Second Line :
City : JACKSON
State : NC
Zip : 27845-9744
Country : US
Telephone Number : 252-534-9977
Fax Number :
Provider Business Practice Location Address
First Line : 9486 HWY 305
Second Line :
City : JACKSON
State : NC
Zip : 27845-9679
Country : US
Telephone Number : 252-534-5111
Fax Number : 252-534-1027
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2006
Last Update Date : 07/08/2007

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Directions to “ KARREN BOONE RICKS LCSW” Practice Location

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