Provider Demographics
NPI:1659458347
Name:RICKELS, KIMBERLY H (LCSW)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:H
Last Name:RICKELS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6787 SATINWOOD CV
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-5627
Mailing Address - Country:US
Mailing Address - Phone:901-491-5606
Mailing Address - Fax:
Practice Address - Street 1:8336 MACON RD
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-8554
Practice Address - Country:US
Practice Address - Phone:901-682-3035
Practice Address - Fax:901-682-3047
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN56461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical