Ricki Audrick
Individual provider Active NPI Social Worker · Lakewood, OH
NPI 1801279294 · NPPES record last updated Jul 2, 2015
Key facts
- NPI
- 1801279294
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- S 1500801 (OH)
- Practice address
- 1357 Clarence Ave
#5
Lakewood, OH 44107-2864 - Phone
- (216) 302-7990
- NPI assigned
- Jul 2, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S 1500801 | OH | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | S 1500801 | OH | |
| Social Worker | 104100000X | S 1500801 | OH | Yes |
| Clinical Social Worker | 1041C0700X | S 1500801 | OH |
Addresses
Primary practice location
1357 Clarence Ave
#5
Lakewood, OH 44107-2864
Mailing address
1357 Clarence Ave
#5
Lakewood, OH 44107-2864
Phone (216) 302-7990
Other providers in Lakewood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.