Provider Demographics
NPI:1003146499
Name:RICARD, ELIZABETH A (MAPC, LPCC-S, NCC)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:A
Last Name:RICARD
Suffix:
Gender:F
Credentials:MAPC, LPCC-S, NCC
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 416
Mailing Address - Street 2:
Mailing Address - City:LOYALL
Mailing Address - State:KY
Mailing Address - Zip Code:40854-0416
Mailing Address - Country:US
Mailing Address - Phone:606-621-5220
Mailing Address - Fax:
Practice Address - Street 1:306 CARTER AVENUE
Practice Address - Street 2:CITY HALL BLDG, ROOM 4
Practice Address - City:LOYALL
Practice Address - State:KY
Practice Address - Zip Code:30854
Practice Address - Country:US
Practice Address - Phone:606-621-5220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-06
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYLPCPCC00222652101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100368520Medicaid