Provider Demographics
NPI:1376362251
Name:RICKERTSEN THERAPY CENTER
Entity type:Organization
Organization Name:RICKERTSEN THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & MARRIAGE FAMILY THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RICKERTSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS LMFT
Authorized Official - Phone:763-245-1970
Mailing Address - Street 1:1150 W SHORE DR SW
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-6740
Mailing Address - Country:US
Mailing Address - Phone:763-245-1970
Mailing Address - Fax:
Practice Address - Street 1:1150 W SHORE DR SW
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-6740
Practice Address - Country:US
Practice Address - Phone:763-245-1970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health