Ricardo Michael Phipps, PH.D, LCPC, LPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2020039217 Issued in MO

Practice address

100 E Normal Ave
Kirksville, MO 63501-4200

Phone

(660) 785-4014

Fax

(660) 785-4011

NPI assigned

Mar 26, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1760069660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E NORMAL AVE",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014200",
            "telephone_number": "660-785-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E NORMAL AVE",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014200",
            "telephone_number": "660-785-4014",
            "fax_number": "660-785-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHIPPS",
        "first_name": "RICARDO",
        "middle_name": "MICHAEL",
        "credential": "PH.D, LCPC, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-26",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2020039217",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC10526",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Andrew Pettit, AU.D.
• Douglas Gene Petty, RPH
• Thao Pham, DO
• Max J Phillips, LCSW
• Ronald Leland Phillips, MD
• Physician Services of Missouri LLC
• Savin Balathandan Pillai, DO
• Matthew Michael Piontek
• Bradley L Polovich, PHARMD
• Sara Elizabeth Poor

• Professional Counselor in Kirksville, MO
• Providers in Kirksville, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.