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General NPI Number Information
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NPI Number | 1578028817
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Entity Type | Individual
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Provider Name | AMBER RICKS PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 01/31/2019
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Last Update Date | 01/31/2019
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Provider Practice Location Address
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Address Line | 12301 ACADEMY WAY
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City | ROCKVILLE
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State | MD
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Zip | 20852-2000
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Country | US
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Telephone | 301-761-2767
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Fax | 301-881-8043
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Provider Business Mailing Address
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Address Line | 8715 1ST AVE APT 401D
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City | SILVER SPRING
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State | MD
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Zip | 20910-3533
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Country | US
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Telephone | 315-746-0573
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1001362
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 944467
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 05983
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License Number State | MD
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