Provider Demographics
NPI:1679217152
Name:RICKS, SARAH KATHERINE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:KATHERINE
Last Name:RICKS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 BETHEL RD NW
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-2178
Mailing Address - Country:US
Mailing Address - Phone:678-477-1559
Mailing Address - Fax:
Practice Address - Street 1:2940 JOHNSON FERRY RD STE B-127
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-8361
Practice Address - Country:US
Practice Address - Phone:678-477-1559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0074391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical