Healthcare Provider Details

I. General information

NPI: 1831412584
Provider Name (Legal Business Name): NICOLE V RICKARD MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE VICTORIA MORLEY

II. Dates (important events)

Enumeration Date: 03/10/2010
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 WASHINGTON ST
MIDLAND MI
48642-3752
US

IV. Provider business mailing address

3101 WASHINGTON ST
MIDLAND MI
48642-3752
US

V. Phone/Fax

Practice location:
  • Phone: 989-294-3173
  • Fax: 989-286-3011
Mailing address:
  • Phone: 989-294-3173
  • Fax: 989-286-3011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401011035
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: