Provider Demographics
NPI:1053858803
Name:RICKER, BRANDON MICHAEL (MS, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:MICHAEL
Last Name:RICKER
Suffix:
Gender:M
Credentials:MS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4900 PERRY HWY
Mailing Address - Street 2:BUILDING 2, SUITE 200
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15229-2220
Mailing Address - Country:US
Mailing Address - Phone:724-850-8118
Mailing Address - Fax:724-850-9500
Practice Address - Street 1:131 MATHEWS ST
Practice Address - Street 2:SUITE 2000
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-6939
Practice Address - Country:US
Practice Address - Phone:724-850-7300
Practice Address - Fax:724-850-7778
Is Sole Proprietor?:No
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009388101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health