Provider Demographics
NPI:1477077675
Name:RICKMAN, DAVID SCOTT (LPC, LAC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:SCOTT
Last Name:RICKMAN
Suffix:
Gender:M
Credentials:LPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8012 S CLAYTON CIR
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-3480
Mailing Address - Country:US
Mailing Address - Phone:720-724-7606
Mailing Address - Fax:
Practice Address - Street 1:8012 S CLAYTON CIR
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-3480
Practice Address - Country:US
Practice Address - Phone:720-724-7606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-28
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0001357101Y00000X
COLPC.0017450101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1477077675Medicaid
CO9000179873Medicaid