Provider Demographics
NPI:1356066351
Name:RICKETTS, ASHARI ROSEMARIE
Entity type:Individual
Prefix:
First Name:ASHARI
Middle Name:ROSEMARIE
Last Name:RICKETTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CHARLESTOWN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-3440
Mailing Address - Country:US
Mailing Address - Phone:857-706-9790
Mailing Address - Fax:
Practice Address - Street 1:895 BLUE HILL AVE # MA02124
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02124-2902
Practice Address - Country:US
Practice Address - Phone:617-825-3400
Practice Address - Fax:617-282-1450
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor