Provider Demographics
NPI:1326171083
Name:VIRGINIA RICKERTSEN
Entity Type:Organization
Organization Name:VIRGINIA RICKERTSEN
Other - Org Name:UNITY COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICKERTSEN
Authorized Official - Suffix:
Authorized Official - Credentials:CDP
Authorized Official - Phone:509-547-9545
Mailing Address - Street 1:303 N 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-4963
Mailing Address - Country:US
Mailing Address - Phone:509-547-9545
Mailing Address - Fax:509-546-0557
Practice Address - Street 1:303 N 20TH AVE
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-4963
Practice Address - Country:US
Practice Address - Phone:509-547-9545
Practice Address - Fax:509-546-0557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1991215OtherDSHS PROVIDER ID
WA1991215OtherDSHS PROVIDER ID