Active NPI
Tammy Jean Ricketts, LICSW
- Counselor
- Saint Louis, MO
National Provider Identifier
1437248556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 0890000987
- Practice address
- 12647 Olive Blvd
Saint Louis, MO 63141-6345 - Phone
- (314) 744-4223
- NPI assigned
- Oct 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 0890000987 | VT | Primary |
Addresses
Primary practice location
12647 Olive Blvd
Saint Louis, MO 63141-6345
Mailing address
11947 McKibben CT
El Paso, TX 79908
Phone (915) 307-4577
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0890000987 | VT | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189641600000",
"number": "1437248556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11947 MCKIBBEN CT",
"city": "EL PASO",
"state": "TX",
"postal_code": "79908",
"telephone_number": "915-307-4577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12647 OLIVE BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631416345",
"telephone_number": "314-744-4223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICKETTS",
"first_name": "TAMMY",
"middle_name": "JEAN",
"name_prefix": "Mrs.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2007-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "VT",
"license": "0890000987",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.