Provider Demographics
NPI:1518178854
Name:RICCARDO AND ASSOCIATES PSC
Entity Type:Organization
Organization Name:RICCARDO AND ASSOCIATES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:RILEY
Authorized Official - Last Name:RICCARDO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:859-223-2813
Mailing Address - Street 1:1082B WELLINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1200
Mailing Address - Country:US
Mailing Address - Phone:859-223-2813
Mailing Address - Fax:859-296-2880
Practice Address - Street 1:1082B WELLINGTON WAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1200
Practice Address - Country:US
Practice Address - Phone:859-223-2813
Practice Address - Fax:859-296-2880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty