Provider Demographics
NPI:1811540115
Name:RICKETT, EMILY NICOLE (MA, LPC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:NICOLE
Last Name:RICKETT
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 GRAPHICS WAY, STE 3100
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-1122
Mailing Address - Country:US
Mailing Address - Phone:740-428-0428
Mailing Address - Fax:740-909-4077
Practice Address - Street 1:7100 GRAPHICS WAY, STE 3100
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-1122
Practice Address - Country:US
Practice Address - Phone:740-428-0428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-17
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2406356101Y00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor