Provider Demographics
NPI:1386288256
Name:MARTIN, RIKKI JEANNE (LCSW)
Entity type:Individual
Prefix:
First Name:RIKKI
Middle Name:JEANNE
Last Name:MARTIN
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:RIKKI
Other - Middle Name:MARTIN
Other - Last Name:HESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3300 BATTLEGROUND AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2490
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9805 STATESVILLE RD STE 6095
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-7647
Practice Address - Country:US
Practice Address - Phone:704-360-5747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0125491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical