RICKEY ETHERIDGE (LPC) – Professional Counselor, NPI 1861594483

RICKEY ETHERIDGE (LPC) is a healthcare provider. based in Little rock, Arkansas. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPC. They hold a License No. P0907039 (AR). The NPI Number for RICKEY ETHERIDGE (LPC) is 1861594483

Main info

Male
Sole Proprietor
21 Years Of Experience
Name
RICKEY ETHERIDGE (LPC)
NPI
1861594483
Phone
(501) 904-4762
Address
11501 Huron Ln Ste 5
Enumeration Date
3 September 2006
Last Update Date
20 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5014433818
Graduation Year
2005 (21 years ago)
PAC ID
3971945130
Professional Enrollment ID
I20240521000403
Address ID
AR720225013BR3348XSTXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness75
Years active:19State licenses:1Digital endpointsOther names

640 MENTAL HEALTH COUNSELOR in AR

Provider Addresses for RICKEY ETHERIDGE (LPC)

  • 11501 Huron Ln Ste 5

    Little Rock, AR 722112491

    Phone: (501) 904-4762

    Fax: (501) 708-2185

    Type: Location

  • 125 WELLNESS WAY

    HOT SPRINGS, AR 719136478

    Phone: (501) 624-7111

    Fax: (501) 603-0324

    Type: Mailing

  • Hardin Road, Little Rock, Pulaski County, Arkansas, 772211, United States

    LITTLE ROCK, AR 722113507

    Phone: (501) 603-2147

    Fax: (501) 603-0324

    Type: Mailing

  • 3348 MAIN ST STE 100

    BRYANT, AR 720225013

    Phone: (501) 443-3824

    Fax: (501) 521-1001

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-05-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240521000403IMental Health CounselorARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 72211)

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Reviews

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Frequently asked questions

Is RICKEY ETHERIDGE (LPC) listed with a National Provider Identifier?
Yes — RICKEY ETHERIDGE (LPC) has NPI 1861594483 on file in the registry.
Is there an active status for RICKEY ETHERIDGE (LPC)?
For scheduling context, RICKEY ETHERIDGE (LPC) is shown as active in the registry.
What kind of doctor is RICKEY ETHERIDGE (LPC)?
RICKEY ETHERIDGE (LPC) is associated with Professional Counselor in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with RICKEY ETHERIDGE (LPC)?
Directory geography for RICKEY ETHERIDGE (LPC) centers on Little Rock, Arkansas.
What does 7 location(s) imply?
7 practice locations appear in the available data.

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