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General NPI Number Information
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NPI Number | 1538553011
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Entity Type | Individual
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Provider Name | MYRA RICKETTS LMHC
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Gender | Female
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Dates
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Enumeration Date | 03/24/2015
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 3404 N LECANTO HWY STE D
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City | BEVERLY HILLS
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State | FL
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Zip | 34465-3569
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Country | US
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Telephone | 352-419-4856
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Fax | 352-877-4162
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Provider Business Mailing Address
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Address Line | PO BOX 2581
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City | INVERNESS
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State | FL
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Zip | 34451-2581
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Country | US
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Telephone | 352-287-9858
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC-0011598
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CC7410
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC0015911
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3417
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License Number State | NH
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH16109
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License Number State | FL
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