Provider Demographics
NPI:1902587264
Name:RICKS, CANDACE ALICIA (LMSW)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:ALICIA
Last Name:RICKS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 4TH ST SW APT 510
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-4486
Mailing Address - Country:US
Mailing Address - Phone:301-288-1045
Mailing Address - Fax:
Practice Address - Street 1:6315 5TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1325
Practice Address - Country:US
Practice Address - Phone:202-671-6080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical