Provider Demographics
NPI:1518210202
Name:RYKERT, PATRICIA (LCSW-R)
Entity type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:
Last Name:RYKERT
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 GULL CV
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-1818
Mailing Address - Country:US
Mailing Address - Phone:631-261-1075
Mailing Address - Fax:
Practice Address - Street 1:222 STATION PLZ N STE 350A
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3814
Practice Address - Country:US
Practice Address - Phone:516-663-2961
Practice Address - Fax:516-663-8971
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0588881041C0700X
NY0865721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical