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Individual

RICKI MATHIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.ED, LPCA

Contact information

Practice address
3221 GOLDTREE CT, LOUISVILLE, KY 40220-3307
(502) 296-9467
Mailing address
3221 GOLDTREE CT, LOUISVILLE, KY 40220-3307
(502) 296-9467

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
281626
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1030187
KY
05
7100948220
KY
Enumeration date
02/15/2017
Last updated
03/27/2024
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