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RICKEY ETHERIDGE LPC
NPI 1861594483
Counselor - Professional in Bryant, AR

Active since September 03, 2006PECOS Enrolled
3348 MAIN ST STE 100, BRYANT, AR 72022(501) 443-3824(501) 521-1001 Get Directions Write a Review

NPPES record last updated: November 20, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 20, 2024, Apr 26, 2024, Nov 10, 2021 and 2 more (5 updates tracked since 2019).

About Rickey Etheridge Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RICKEY ETHERIDGE LPC (NPI 1861594483) is an individual professional provider in Bryant, Arkansas, licensed in Arkansas (P0907039) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Little Rock, and is a graduate of Other (2005).

NPPES Registry Identity

NPI1861594483
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameRICKEY ETHERIDGECredential: LPC
Location Address3348 MAIN ST STE 100Bryant, AR 72022-5013
Mailing Address3348 Main St Ste 100Bryant, AR 72022-5013 · (501) 443-3824 · Fax (501) 521-1001
Phone(501) 443-3824
Fax(501) 521-1001
Sole ProprietorYes
Medical School CMSOtherGraduated 2005
Enumeration DateSeptember 3, 2006
Last NPPES UpdateNovember 20, 20245 updates tracked since enumeration
NPPES CertifiedNovember 20, 2024
✔ NPI 1861594483 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in AR · P0907039
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License P0907039 (AR)
3348 MAIN ST STE 100, Bryant, AR 72022
Open in Google Maps ↗

Secondary Practice Location 1

Location 111501 Huron Ln Ste 5Little Rock, AR 72211-2491 · Phone (501) 904-4762 · Fax (501) 708-2185

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Arkansas Blue Cross and Blue Shield, Health Advantage, Octave.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Rickey Etheridge Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3971945130
PECOS Enrollment IDI20240521000403
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychiatric diagnostic evaluation 90791
A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.
15 services15 patients

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRISTIN N KIERNAN APRN PLLC
Nurse Practitioner (Psychiatric/Mental Health)
3348 MAIN ST STE 100
BRYANT, AR 72022
Saline County (501) 443-3818
KRISTIN KIERNAN
Nurse Practitioner (Psychiatric/Mental Health)
3348 MAIN ST STE 100
BRYANT, AR 72022
Saline County (501) 443-3818
LIFES SILVER LININGS LLC
Social Worker (Clinical)
3348 MAIN ST STE 100
BRYANT, AR 72022
Saline County (501) 443-3818

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rickey Etheridge's NPI number?

The NPI number for Rickey Etheridge is 1861594483. It was assigned to this individual provider in the NPPES registry on September 3, 2006.

Where is Rickey Etheridge located?

Rickey Etheridge practices at 3348 Main St Ste 100, Bryant, AR 72022. The listed phone number is (501) 443-3824.

What is Rickey Etheridge's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Rickey Etheridge enrolled in Medicare?

Yes. Rickey Etheridge is registered in the Medicare PECOS enrollment system.

What insurance does Rickey Etheridge accept?

Health plans from Arkansas Blue Cross and Blue Shield, Health Advantage and Octave list Rickey Etheridge as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Rickey Etheridge was last updated on November 20, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.