MEDICARE: TRICO CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor		MD

General Provider Information

NPI Number	:	1275514671
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRICO CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 826
Second Line	:
City	:	LEXINGTON PARK
State	:	MD
Zip	:	20653-0826
Country	:	US
Telephone Number	:	301-862-4961
Fax Number	:	301-862-5554

Provider Business Practice Location Address
First Line	:	46940 S SHANGRI LA DR
Second Line	:
City	:	LEXINGTON PARK
State	:	MD
Zip	:	20653-1037
Country	:	US
Telephone Number	:	301-862-4961
Fax Number	:	301-862-5554

Authorized Official
Title or Position	:	PRESIDENT TRICO CORPORATION
Name	:	WILLIAM E ARICK
Credential	:	MDIV LCPC NCC ACS
Telephone Number	:	301-862-4961

Provider Enumeration Date	:	11/11/2005
Last Update Date	:	03/03/2011

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Directions to “TRICO CORPORATION ” Practice Location

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