Keely Gahm Ricks, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904005164 Issued in VA

Practice address

3675 Mary Lou LN
Melbourne, FL 32934-8389

Phone

(321) 408-2178

NPI assigned

Jan 2, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Buckhorn Lane Counseling, PLLC

  • Clinical Social Worker
  • Fredericksburg, VA
  • NPI 1235433699
  NPD (past)
• Rappahannock Area Community Services Board

  • Community/Behavioral Health Agency
  • Fredericksburg, VA
  • NPI 1790742153
  NPD (past)
• Stepping Stones Counseling & Therapy, PLLC

  • Community/Behavioral Health Agency
  • Fredericksburg, VA
  • NPI 1275865172
  NPD (past)

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

{
    "created_epoch": "1262390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1184954869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3675 MARY LOU LN",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329348389",
            "telephone_number": "321-408-2178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 MARY LOU LN",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329348389",
            "telephone_number": "321-408-2178"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2217 Princess Anne St",
            "address_2": "Suite 105-5",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224013353",
            "country_code": "US",
            "telephone_number": "540-371-1006",
            "fax_number": "540-371-1911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICKS",
        "first_name": "KEELY",
        "middle_name": "GAHM",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-02",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904005164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie April Richardson, ARNP
• Peyton Lynn Richardson, PT, DPT
• Ronald Edward Richardson Jr., DDS
• Tiffany Pamela Richason, M.D.
• Mary Margaret Louise Richter, ARNP
• Sean Thomas Ricks, M.DIV.
• Michelle Riddle
• Eve M Rider, DO
• Carissa Joy Ridgley
• Gabriella Lynn Ridout

• Clinical Social Worker in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.