Provider Demographics
NPI:1295448264
Name:RICKS, JANICE LOUISE (LCSW-S & LISW-S)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:LOUISE
Last Name:RICKS
Suffix:
Gender:F
Credentials:LCSW-S & LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 E LAKEVIEW ST
Mailing Address - Street 2:
Mailing Address - City:UMATILLA
Mailing Address - State:FL
Mailing Address - Zip Code:32784-9588
Mailing Address - Country:US
Mailing Address - Phone:407-489-2860
Mailing Address - Fax:
Practice Address - Street 1:181 E LAKEVIEW ST
Practice Address - Street 2:
Practice Address - City:UMATILLA
Practice Address - State:FL
Practice Address - Zip Code:32784-9588
Practice Address - Country:US
Practice Address - Phone:407-489-2860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI06000281041C0700X
FLSW68161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical