Roberta T Ricketts, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1427 Issued in OR

Practice address

522 SW 5TH Ave
Suite 725
Portland, OR 97204-2133

Phone

(503) 222-2448

Fax

(503) 222-2395

NPI assigned

Jul 25, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

• Joseph Rhinewine, PHD, PC

  dba Portland Mindfulness Therapy

  • Clinical Psychologist
  • Portland, OR
  • NPI 1578892386
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952324469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 SW 5TH AVE",
            "address_2": "SUITE 725",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972042133",
            "telephone_number": "503-222-2448",
            "fax_number": "503-222-2395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 SW 5TH AVE",
            "address_2": "SUITE 725",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972042133",
            "telephone_number": "503-222-2448",
            "fax_number": "503-222-2395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKETTS",
        "first_name": "ROBERTA",
        "middle_name": "T",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "1427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFIC SOURCE",
            "identifier": "J930714",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Jean Ricker
• Hydee Rickert, MA, QMHP
• Rebecca Lynn Ricketson
• Hamish Rickett, MD
• Reva S. Ricketts-Loriaux, D.O.
• Rickland G Asai DMD
• Rickland G Asai DMD
• Sandra Joy Rickman, PHARM.D., RPH
• Adam Ricks
• Nicole Ricksgers

• Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.