Provider Demographics
NPI:1548740277
Name:RICKS, COURTNEY ALYSSA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:ALYSSA
Last Name:RICKS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:ALYSSA
Other - Last Name:LANCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:10262 TRACERY CT
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-9540
Mailing Address - Country:US
Mailing Address - Phone:720-217-7672
Mailing Address - Fax:
Practice Address - Street 1:5690 DTC BLVD STE 120W
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-3255
Practice Address - Country:US
Practice Address - Phone:720-217-7672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX565051041C0700X
COCSW.099254031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical