Jake Edwin Ricketson in High Point - Clinical
Jake Edwin Ricketson - NPI 1356409734
Jake Edwin Ricketson is a Clinical in High Point, North Carolina. Jake Edwin Ricketson practices all healthcare services and medical treatments related to Clinical. The NPI Number for Jake Edwin Ricketson is 1356409734. The last update date is 2012-02-09.
Jake Edwin Ricketson's current location address is 405 Westwood Ave, High Point, North Carolina. You can contact this provider via phone number 3368877350 and fax number 3368877353. The mailing address for Jake Edwin Ricketson is 405 Westwood Ave, High Point, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jake Edwin Ricketson |
|---|---|
| Address | 405 Westwood Ave, High Point, North Carolina |
| Phone Number | 3368877350 |
| Fax Number | 3368877353 |
| Sole Proprietor | Y |
| Credentials | PSYD |
NPI Number Detail
| NPI Number | 1356409734 |
|---|---|
| Provider Enumeration Date | 2006-12-05 |
| Last Updated Date | 2012-02-09 |
Provider Mailing Address Detail
| Address | 405 Westwood Ave |
|---|---|
| City | High Point |
| State | North Carolina (NC) |
| Post Code | 272624325 |
| Phone Number | 3368877350 |
| Fax Number | 3368877353 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 1167 |
|
Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4492 | NC | BCBS PRIVATE INSURANCE | |
| 6000026 | NC | -- | |
| 21519 | NC | MEDCAST PRIVATE INSURANCE |
Post Comment/ Review Below
What is the Jake Edwin Ricketson's 1356409734?
The Jake Edwin Ricketson's NPI (National Provider Identifier) Number is 1356409734. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Jake Edwin Ricketson is geographically located?
The Jake Edwin Ricketson is physically situated at the following location: 405 Westwood Ave, High Point, NC, 272624325.
What is the area of specialization for Jake Edwin Ricketson, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Jake Edwin Ricketson is Clinical, and the corresponding taxonomy code that categorizes this area of expertise is 103Tc0700X.
On what date was the 1356409734 assigned to Jake Edwin Ricketson?
The Jake Edwin Ricketson was issued its 1356409734 on 2006-12-05, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Jake Edwin Ricketson last refreshed?
The information related to the Jake Edwin Ricketson, including its address, specialty, and other relevant details, was last updated on 2012-02-09.