Provider Demographics
NPI:1295380061
Name:RICKERT, ABIGAIL M (LISW)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:M
Last Name:RICKERT
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4730 LOREN DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-8023
Mailing Address - Country:US
Mailing Address - Phone:319-575-0550
Mailing Address - Fax:
Practice Address - Street 1:3251 W 9TH ST
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5310
Practice Address - Country:US
Practice Address - Phone:319-234-2893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical