Active NPI
Rickey Woolfolk
- Behavior Analyst
- Queen Creek, AZ
National Provider Identifier
1821305657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 2400630
- Practice address
- 3644 W Goldmine Mountain Dr
Queen Creek, AZ 85142-6593 - Phone
- (520) 891-2067
- NPI assigned
- Aug 31, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 2400630 | AZ | Primary |
Addresses
Primary practice location
3644 W Goldmine Mountain Dr
Queen Creek, AZ 85142-6593
Mailing address
3644 W Goldmine Mountain Dr
Queen Creek, AZ 85142-6593
Phone (520) 891-2067
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 |
|---|---|---|---|
| 2400630 | AZ | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283212800000",
"number": "1821305657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3644 W GOLDMINE MOUNTAIN DR",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "851426593",
"telephone_number": "520-891-2067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3644 W GOLDMINE MOUNTAIN DR",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "851426593",
"telephone_number": "520-891-2067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOLFOLK",
"first_name": "RICKEY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-08-31",
"last_updated": "2010-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "AZ",
"license": "2400630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Queen Creek, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.