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General NPI Number Information
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NPI Number | 1528971439
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Entity Type | Individual
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Provider Name | TONYA RICKETTS LPCC
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Gender | Female
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Dates
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Enumeration Date | 09/23/2026
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Last Update Date | 09/24/2026
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Provider Practice Location Address
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Address Line | 1015 DORSEY LN
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City | LOUISVILLE
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State | KY
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Zip | 40223-2612
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Country | US
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Telephone | 502-616-1991
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Fax |
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Provider Business Mailing Address
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Address Line | 235 E LAKEVIEW DR
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City | MOUNT WASHINGTON
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State | KY
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Zip | 40047-7037
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Country | US
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Telephone | 502-403-0560
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 291788
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License Number State | KY
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