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General NPI Number Information
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NPI Number | 1659458347
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Entity Type | Individual
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Provider Name | KIMBERLY H RICKELS LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 8336 MACON RD
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City | CORDOVA
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State | TN
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Zip | 38018-8554
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Country | US
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Telephone | 901-682-3035
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Fax | 901-682-3047
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Provider Business Mailing Address
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Address Line | 6787 SATINWOOD CV
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City | MEMPHIS
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State | TN
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Zip | 38119-5627
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Country | US
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Telephone | 901-491-5606
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 5646
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License Number State | TN
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