Provider Demographics
NPI:1679976062
Name:CALVERT, RIKKI D (LCSW)
Entity type:Individual
Prefix:
First Name:RIKKI
Middle Name:D
Last Name:CALVERT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 742
Mailing Address - Street 2:
Mailing Address - City:ALTA
Mailing Address - State:CA
Mailing Address - Zip Code:95701-0742
Mailing Address - Country:US
Mailing Address - Phone:916-932-8188
Mailing Address - Fax:
Practice Address - Street 1:4935 HILLSDALE CIRCLE
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762
Practice Address - Country:US
Practice Address - Phone:916-932-8188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASUDCC8001101YA0400X
CALCSW107296101YM0800X, 1041C0700X
CAASW83114101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical