Individual provider Active NPI

Mary Elizabeth Ricketts, LCSW

  • Mental Health Counselor
  • Phoenix, AZ
National Provider Identifier
1417992124
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCSW 11539 Issued in AZ
Practice address
5050 N 8TH PL
Suite 8
Phoenix, AZ 85014-3202
Phone
(602) 285-9696
Fax
(602) 277-5930
NPI assigned
Jun 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LCSW 11539 AZ
Mental Health Counselor 101YM0800X LCSW 11539 AZ Primary

Addresses

Primary practice location

5050 N 8TH PL
Suite 8
Phoenix, AZ 85014-3202

Mailing address

16560 W Woodlands Ave
Goodyear, AZ 85338-2725
Phone (602) 285-9696

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW 11539AZMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
North Community Counseling Centers Inc PastSince Nov 1, 1999 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/northcommunity/r4/

Organizations & group practices 1

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1417992124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16560 W WOODLANDS AVE",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853382725",
            "telephone_number": "602-285-9696",
            "fax_number": "602-277-5930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 N 8TH PL",
            "address_2": "SUITE 8",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850143202",
            "telephone_number": "602-285-9696",
            "fax_number": "602-277-5930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKETTS",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AZ",
            "license": "LCSW 11539",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LCSW 11539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.