Lawan Rickenbacker, PSYD

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

28 Treadwell Ave
Staten Island, NY 10302

Phone

(917) 741-3224

NPI assigned

Jun 1, 2018

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

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

{
    "created_epoch": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1548752983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 TREADWELL AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103021240",
            "telephone_number": "917-741-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 TREADWELL AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10302",
            "telephone_number": "917-741-3224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "930 Willowbrook Rd # B14E",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103144209",
            "country_code": "US",
            "telephone_number": "917-741-3224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICKENBACKER",
        "first_name": "LAWAN",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-01",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richmond University Medical Center Adolescent Program
• Richmond Valley Pharmacy Inc
• Bluma Richt
• David Matthew Rick, MHC-LP
• Shannon Rick
• Marjorie Jeanne Rico, M.D., PH.D.
• Tiarra Lashay Riddick
• Jessica Ann Riepe, P.A.
• Michelle Rifkin-Mamaradlo, L.M.S.W.
• Cristen Rigatti

• Counselor in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2018; 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.