Provider Demographics
NPI:1972043198
Name:RICKS, CHAD S SR (MA, LPCC)
Entity Type:Individual
Prefix:MR
First Name:CHAD
Middle Name:S
Last Name:RICKS
Suffix:SR
Gender:M
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 EXECUTIVE PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SHARONVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45241-2023
Mailing Address - Country:US
Mailing Address - Phone:513-274-2744
Mailing Address - Fax:513-978-0144
Practice Address - Street 1:4000 EXECUTIVE PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:SHARONVILLE
Practice Address - State:OH
Practice Address - Zip Code:45241-2023
Practice Address - Country:US
Practice Address - Phone:513-274-2744
Practice Address - Fax:513-978-0144
Is Sole Proprietor?:No
Enumeration Date:2017-03-07
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC 1300217101YM0800X
OHE.2102371101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health