Provider Demographics
NPI:1699216036
Name:RICCI, AMANDA (LADC, CCS, RN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:RICCI
Suffix:
Gender:
Credentials:LADC, CCS, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE FALLS
Mailing Address - State:ME
Mailing Address - Zip Code:04254-1529
Mailing Address - Country:US
Mailing Address - Phone:207-320-3305
Mailing Address - Fax:207-645-2372
Practice Address - Street 1:76 MAIN ST
Practice Address - Street 2:
Practice Address - City:LIVERMORE FALLS
Practice Address - State:ME
Practice Address - Zip Code:04254-1529
Practice Address - Country:US
Practice Address - Phone:207-320-3305
Practice Address - Fax:207-645-2372
Is Sole Proprietor?:No
Enumeration Date:2017-03-18
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECCS7464101YA0400X
ME31763146N00000X
MERN88104163W00000X
MELC6593101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No163W00000XNursing Service ProvidersRegistered Nurse