| Doctor Name: | MR. DAVID J. RICCARDI |
| NPI Number: | 1497946958 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPCC, LICDC, NCC |
| License Number: | E1269, 852145 |
| Business Practice Address: | 5564 Wilson Mills Rd Ste 201 Highland Heights, OH - 441433265 |
| Business Phone Number: | 4404611255 |
| Business Fax Number: | 4404611047 |
| Mailing Address: | 5564 Wilson Mills Rd Ste 201, HIGHLAND HEIGHTS |
| State: | OH |
| Postal Code: | 441433265 |
| Phone Number: | 4404611255 |
| Fax Number: | 4404611047 |
| NPI Enumeration Date: | 08/08/2007 |
| NPI Last Update Date: | 10/31/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | E1269, 852145 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |