Provider Demographics
NPI:1982032694
Name:TRICO CLINICAL SERVICES, LTD
Entity Type:Organization
Organization Name:TRICO CLINICAL SERVICES, LTD
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:LCPC
Authorized Official - Phone:301-862-4961
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:301-862-4961
Mailing Address - Fax:301-862-5554
Practice Address - Street 1:46707 S. SHANGRI LA DRIVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653
Practice Address - Country:US
Practice Address - Phone:301-862-4961
Practice Address - Fax:301-862-5554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health