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General NPI Number Information
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NPI Number | 1972043198
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Entity Type | Individual
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Provider Name | CHAD S RICKS SR. MA, LPCC
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Gender | Male
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Dates
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Enumeration Date | 03/07/2017
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Last Update Date | 07/27/2021
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Provider Practice Location Address
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Address Line | 4000 EXECUTIVE PARK DR STE 100
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City | SHARONVILLE
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State | OH
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Zip | 45241-2023
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Country | US
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Telephone | 513-274-2744
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Fax | 513-978-0144
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Provider Business Mailing Address
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Address Line | 4000 EXECUTIVE PARK DR STE 100
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City | SHARONVILLE
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State | OH
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Zip | 45241-2023
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Country | US
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Telephone | 513-274-2744
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Fax | 513-978-0144
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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 | C 1300217
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E.2102371
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License Number State | OH
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