Individual
ELIZABETH RENEE RICKETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 EDGARTOWN VINEYARD HAVEN RD, VINEYARD HAVEN, MA 02568-5699
(508) 684-8126
(508) 696-0401
Mailing address
111 EDGARTOWN VINEYARD HAVEN RD, VINEYARD HAVEN, MA 02568-5699
(508) 684-8126
(508) 696-0401
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
U78904309
MA
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
CHW1361
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CHW01361
COMMUNITY HEALTH WORKER
MA
01
—
U78904309
BOSTONUNIVERSITY
MA
Enumeration date
01/12/2018
Last updated
11/21/2025
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