Healthcare Provider Details

I. General information

NPI: 1467389239
Provider Name (Legal Business Name): RICKY MCCANTS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ALABAMA A&M UNIVERSITY 104 BUCHANAN HALL
NORMAL AL
35762
US

IV. Provider business mailing address

ALABAMA A&M UNIVERSITY 104 BUCHANAN HALL
NORMAL AL
35762
US

V. Phone/Fax

Practice location:
  • Phone: 251-652-8215
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number9776835
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: