Ricketts, Elizabeth Renee

Ricketts, Elizabeth Renee is an individual health care provider with primary practice located at 111 Edgartown Vineyard Haven Rd , Vineyard Haven MA 02568-5699. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Other Service Providers / Case Manager/Care Coordinator, Other Service Providers / Peer Specialist, Other Service Providers / Community Health Worker. Other Service Providers / Community Health Worker is her primary health care specialty. Ricketts, Elizabeth Renee can be contacted via phone (508) 684-8126.

Contact Information

Primary practice address
111 Edgartown Vineyard Haven Rd Vineyard Haven MA 02568-5699
Phone: (508) 684-8126
Fax: (508) 696-0401
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Other Service Providers / Peer Specialist 175T00000X
Other Service Providers / Community Health Worker 172V00000X CHW1361 Massachusetts

Profile Details

NPI number 1538677521
LBN Legal business name Ricketts, Elizabeth Renee
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 12th, 2018
Last updated Jul 11th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538677521 NPPES
Massachusetts Other CHW01361 COMMUNITY HEALTH WORKER

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