Provider Demographics
NPI:1790817674
Name:TRICO CORPORATION
Entity Type:Organization
Organization Name:TRICO CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:ARICK
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV,LCPC,NCC,ACS
Authorized Official - Phone:301-862-4966
Mailing Address - Street 1:P.O. BOX 826
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20653
Mailing Address - Country:US
Mailing Address - Phone:301-862-4966
Mailing Address - Fax:301-862-5554
Practice Address - Street 1:2670 CRAIN HIGHWAY, SUITE 525
Practice Address - Street 2:SMALLWOOD BUILDING
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20621
Practice Address - Country:US
Practice Address - Phone:310-632-2100
Practice Address - Fax:301-632-2150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty