Rita Dyanne Ickert

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

307 W Cota St
Shelton, WA 98584-2265

Phone

(360) 205-8001

NPI assigned

Feb 22, 2023

Sex

Female

Sole proprietor

Yes

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

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Olympic Health and Recovery Services

  • Community/Behavioral Health Agency
  • Lacey, WA
  • NPI 1760007504
  NPD
• Thurston Mason Behavioral Health Organization

  • Community/Behavioral Health Agency
  • Lacey, WA
  • NPI 1265932198
  NPD (past)

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

{
    "created_epoch": "1677024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1821796483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 Y ST SW",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985015263",
            "telephone_number": "360-205-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 W COTA ST",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985842265",
            "telephone_number": "360-205-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICKERT",
        "first_name": "RITA",
        "middle_name": "DYANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-22",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CAAR.CG.61414172",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ingrid Hughes, PHARMD
• Diane Rene Huisingh, LMP
• Margaret Katherine Hults
• Michelle Ann Hults
• Danielle Hutchins, RN, IBCLC
• Ideas Unlimited Inc
• Heung In
• Joshua Ireland
• Sarah E Jacob, LPN, LMP
• Carley A Jacobs, PA-C

• Peer Specialist in Shelton, WA
• Providers in Shelton, WA by specialty
• Peer Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; 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.