Individual provider Active NPI

Robert B Rickle Jr., LCSW

  • Clinical Social Worker
  • Silver City, NM
National Provider Identifier
1336739622
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-10925 Issued in NM
Practice address
2039 Cottage San Rd
Silver City, NM 88061-8968
Phone
(575) 956-8698
NPI assigned
Jan 21, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C-10925 NM Primary

Addresses

Primary practice location

2039 Cottage San Rd
Silver City, NM 88061-8968

Mailing address

415 W Michigan St
Silver City, NM 88061-4644
Phone (575) 956-8698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C-10925NMMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1336739622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W MICHIGAN ST",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "880614644",
            "telephone_number": "575-956-8698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2039 COTTAGE SAN RD",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "880618968",
            "telephone_number": "575-956-8698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKLE",
        "first_name": "ROBERT",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-21",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-10925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver City, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.