Provider Demographics
NPI:1235573585
Name:RIKE, KERY LANE (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:KERY
Middle Name:LANE
Last Name:RIKE
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 E LAMAR BLVD
Mailing Address - Street 2:STE 214
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-4510
Mailing Address - Country:US
Mailing Address - Phone:817-624-1222
Mailing Address - Fax:817-460-0286
Practice Address - Street 1:920 ROBERTS CUT OFF RD
Practice Address - Street 2:STE A
Practice Address - City:RIVER OAKS
Practice Address - State:TX
Practice Address - Zip Code:76114-2826
Practice Address - Country:US
Practice Address - Phone:817-624-1222
Practice Address - Fax:817-624-1213
Is Sole Proprietor?:No
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202045106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist