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General NPI Number Information
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NPI Number | 1053858803
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Entity Type | Individual
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Provider Name | BRANDON MICHAEL RICKER MS, NCC, LPC
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Gender | Male
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Dates
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Enumeration Date | 01/31/2017
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Last Update Date | 01/31/2017
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Provider Practice Location Address
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Address Line | 131 MATHEWS ST SUITE 2000
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City | GREENSBURG
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State | PA
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Zip | 15601-6939
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Country | US
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Telephone | 724-850-7300
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Fax | 724-850-7778
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Provider Business Mailing Address
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Address Line | 4900 PERRY HWY BUILDING 2, SUITE 200
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City | PITTSBURGH
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State | PA
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Zip | 15229-2220
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Country | US
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Telephone | 724-850-8118
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Fax | 724-850-9500
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC009388
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License Number State | PA
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