Provider Demographics
NPI:1457386658
Name:RYKIEL, CHRISTINE M (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:M
Last Name:RYKIEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2970 UNIVERSITY PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2401
Mailing Address - Country:US
Mailing Address - Phone:941-391-1399
Mailing Address - Fax:
Practice Address - Street 1:2970 UNIVERSITY PKWY STE 201
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2401
Practice Address - Country:US
Practice Address - Phone:941-391-1399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD095401041C0700X
FLSW102951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006475700Medicaid
FL006475700Medicaid
FLGC731AMedicare PIN
FL006475700Medicaid