Healthcare Provider Details

I. General information

NPI: 1568370773
Provider Name (Legal Business Name): JOHN RICKETSON PSYCHIATRIC NURSE PRACTITIONER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 ELM ST
COHASSET MA
02025-1829
US

IV. Provider business mailing address

76 JUDSON RD
WEYMOUTH MA
02188-1415
US

V. Phone/Fax

Practice location:
  • Phone: 781-927-8143
  • Fax:
Mailing address:
  • Phone: 781-927-8143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JOHN RICKETSON
Title or Position: CEO
Credential: PMHNP
Phone: 781-927-8143