MR. RICKY A PERSON SR. (NPI# 1144651159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144651159 |
| Entity Type | Individual |
| Full Name | MR. RICKY A PERSON SR. |
| Credential | CSAC. ICS |
| Practice Address |
4810 Northwestern Ave Mount Pleasant WI 53406 |
| Mailing Address |
4810 Northwestern Ave # 100 Mount Pleasant WI 53406-1504 |
| Practice Telephone | 2625832714 |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2018-07-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
11919-134 | WI | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2405 Northwestern Ave, Suite Ll15, Racine, WI 534042534 | 2622608370 |
| Street Address |
4810 NORTHWESTERN AVE |
| City | MOUNT PLEASANT |
| State | WI |
| Zip Code | 53406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104901222 | Susan E Moore Schneider | Social Worker | 4810 Northwestern Ave, Mount Pleasant, WI 53406-1504 | 2006-10-26 |
| 1760039085 | Stacey L Adams | Social Worker | 4810 Northwestern Ave, Mount Pleasant, WI 53406-1504 | 2019-08-21 |
| 1992290381 | Jacqueline Venesia Mcrae | Counselor | 4810 Northwestern Ave, Mount Pleasant, WI 53406-1504 | 2018-06-27 |
| 1437485984 | Karla J Bidstrup | Social Worker | 4810 Northwestern Ave, Mount Pleasant, WI 53406-1504 | 2009-10-19 |
| 1740309699 | Sheryl Ann Dean | Counselor | 4810 Northwestern Ave, Mount Pleasant, WI 53406-1504 | 2007-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164349 | Lynn Huynh | Pharmacist | 5695 Washington Ave, Racine, WI 53406 | 2020-11-06 |
| 1659920049 | Carol Jean Cornejo | Technician | 6528 Heritage Avenue, Mt Pleasant, WI 53406 | 2019-09-09 |
| 1265913958 | Mary Goldbeck | Social Worker | 1775 Newman Rd, Mt Pleasant, WI 53406 | 2018-08-22 |
| 1669963344 | Kelly Nicole Nelson | Registered Nurse | 8800 Washington Ave Ste 200, Mount Pleasant, WI 53406 | 2018-05-29 |
| 1891212163 | Ilona Agata Pryomski | Nurse Practitioner | 9201 Washington Ave, Racine, WI 53406 | 2017-08-27 |
| 1386185106 | Margaret M. Abaogye Dds | Dentist | 4340 Newman Rd., Racine, WI 53406 | 2017-03-13 |
| 1508309212 | Rebecca Koeppen | Dietitian, Registered | 8400 Washington Ave., Racine, WI 53406 | 2016-11-29 |
| 1386194371 | Forefront Dermatology, S.c. | Dermatology | 7200 Washington Ave, Suite 100, Mount Pleasant, WI 53406 | 2016-10-13 |
| 1356891402 | Forefront Dermatology, S.c. | Dermatology | 1515 S Green Bay Rd, Racine, WI 53406 | 2016-10-12 |
| 1861841470 | Leah Marie Johnson | Dentist | 1101 South Airline Road, Racine, WI 53406 | 2016-06-06 |
| Find all providers in zip 53406 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336747476 | Todd Schuster | Counselor | 4273 Corporate Dr, Mount Pleasant, MI 48858-5321 | 2020-10-12 |
| 1528674330 | Alicia S Balistreri | Counselor | 5735 Durand Ave, Mount Pleasant, WI 53406-5011 | 2020-09-17 |
| 1568023943 | Terri Lee Wallow | Counselor | 5735 Durand Ave, Mount Pleasant, WI 53406-5011 | 2019-06-26 |
| 1649745340 | Miriam E Corona | Counselor | 5735 Durand Ave, Mount Pleasant, WI 53406-5011 | 2018-10-09 |
| 1992290381 | Jacqueline Venesia Mcrae | Counselor | 4810 Northwestern Ave, Mount Pleasant, WI 53406-1504 | 2018-06-27 |
| 1619480571 | Sarah Marie Jaeck | Counselor | 5735 Durand Ave, Mount Pleasant, WI 53406-5011 | 2017-11-14 |
| 1740729219 | Samantha Lynn Jendza | Counselor | 4273 Corporate Dr, Mount Pleasant, MI 48858-5321 | 2017-02-17 |
| 1922544881 | Seth Oketch | Counselor | 5735 Durand Ave Ste A, Mount Pleasant, WI 53406-5011 | 2017-01-16 |
| 1821530965 | Andrew Keeley | Counselor | 4273 Corporate Dr, Mount Pleasant, MI 48858-5321 | 2016-11-07 |
| 1215300538 | Andrews King | Counselor | 5735 Durand Ave, Suite A, Mount Pleasant, WI 53406-5011 | 2015-11-09 |
| Find all providers in MOUNT PLEASANT | ||||
| City | MOUNT PLEASANT |
| Zip Code | 53406 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.