Provider Demographics
NPI:1407577075
Name:RICKIE FLECK LCSW PLLC
Entity Type:Organization
Organization Name:RICKIE FLECK LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RICKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-560-7138
Mailing Address - Street 1:4360 MATHER
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-9288
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4360 MATHER
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-9288
Practice Address - Country:US
Practice Address - Phone:512-978-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty