Healthcare Provider Details

I. General information

NPI: 1609888056
Provider Name (Legal Business Name): JOHN C. ARICK JR. M.A., L.P.C.M.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1059 S BRADFORD ST
DOVER DE
19904-4141
US

IV. Provider business mailing address

1059 S BRADFORD ST
DOVER DE
19904-4141
US

V. Phone/Fax

Practice location:
  • Phone: 302-736-6135
  • Fax: 302-736-0172
Mailing address:
  • Phone: 302-736-6135
  • Fax: 302-736-0172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC-0000357
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: