Healthcare Provider Details

I. General information

NPI: 1124954920
Provider Name (Legal Business Name): MEGAN RICKERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 W MUSKEGON DR
GREENFIELD IN
46140-3069
US

IV. Provider business mailing address

201 S SHORTRIDGE RD
INDIANAPOLIS IN
46219-7441
US

V. Phone/Fax

Practice location:
  • Phone: 317-468-6200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: