Provider Demographics
NPI:1790813731
Name:RICKARDS, WILLIAM (MA, LMFT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:RICKARDS
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1493
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-1493
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:65-1206 MAMALAHOA HWY
Practice Address - Street 2:BLDG. 2, OFFICE 2
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-7303
Practice Address - Country:US
Practice Address - Phone:808-990-3875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI151106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist