Active NPI
Tammy Lynn Ridoutt, LSW
- Clinical Social Worker
- Maumee, OH
National Provider Identifier
1407547631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- S.2309080
- Practice address
- 1655 Holland Rd Ste F
Maumee, OH 43537-1656 - Phone
- (833) 510-4357
- NPI assigned
- May 18, 2023
- Last updated
- Oct 8, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | S.2309080 | OH | Primary |
Addresses
Primary practice location
1655 Holland Rd Ste F
Maumee, OH 43537-1656
Mailing address
4600 Montgomery Rd Ste 400
Cincinnati, OH 45212-2600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.2309080 | OH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728345600000",
"number": "1407547631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4600 MONTGOMERY RD STE 400",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452122600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1655 HOLLAND RD STE F",
"city": "MAUMEE",
"state": "OH",
"postal_code": "435371656",
"telephone_number": "833-510-4357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDOUTT",
"first_name": "TAMMY",
"middle_name": "LYNN",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-18",
"last_updated": "2024-10-08",
"certification_date": "2024-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "S.2309080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maumee, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.