Individual provider Active NPI

Lakaren Deann Rickman, PH.D.

  • Clinical Psychologist
  • Columbus, GA
National Provider Identifier
1104166578
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY004241 Issued in GA
Practice address
2100 Comer Ave
Columbus, GA 31904-8725
Phone
(706) 596-5500
Fax
(706) 596-5539
NPI assigned
Feb 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X PSY004241 GA
Clinical Child & Adolescent Psychologist 103TC2200X PSY004241 GA
Health Psychologist 103TH0004X PSY004241 GA
Health Service Psychologist 103TH0100X PSY004241 GA
Clinical Psychologist 103TC0700X PSY004241 GA Primary

Addresses

Primary practice location

2100 Comer Ave
Columbus, GA 31904-8725

Mailing address

2100 Comer Ave
Columbus, GA 31904-8725
Phone (706) 596-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220722000232 GA Practitioner - Clinical Psychologist 5395985220 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY004241GAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercymed of Columbus Inc CurrentSince Oct 22, 2023 Accepting new patients
Winchester Community Mental Health Center, Inc. CurrentSince Jun 1, 2013 Accepting new patients
Valley Physician Enterprise Inc Past Accepting new patients
Valley Physician Enterprise, Inc. Past Accepting new patients

Locations

3679 Steam Mill Rd
Columbus, GA 31906
Phone (706) 507-4687

36 Ricketts Dr
Winchester, VA 22601
Phone (540) 535-1112

20B Ricketts Dr
Winchester, VA 22601
Phone (540) 535-1112

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1361491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1104166578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 COMER AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319048725",
            "telephone_number": "706-596-5500",
            "fax_number": "706-965-5539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 COMER AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319048725",
            "telephone_number": "706-596-5500",
            "fax_number": "706-596-5539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKMAN",
        "first_name": "LAKAREN",
        "middle_name": "DEANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-22",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "GA",
            "license": "PSY004241",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "GA",
            "license": "PSY004241",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "GA",
            "license": "PSY004241",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "GA",
            "license": "PSY004241",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY004241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.