Healthcare Provider Details

I. General information

NPI: 1922388420
Provider Name (Legal Business Name): RICKY H LAWSON APRN, RN, LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2011
Last Update Date: 08/07/2020
Certification Date: 08/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VA BOSTON HEALTHCARE SYSTEM 251 CAUSEWAY ST, 3RD FLOOR
BOSTON MA
02114
US

IV. Provider business mailing address

251 CAUSEWAY ST FL 3
BOSTON MA
02114-2148
US

V. Phone/Fax

Practice location:
  • Phone: 617-248-1053
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN2295821
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2295821
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: