Individual provider Active NPI

Laquitha R Ridgeway

  • Professional Counselor
  • Meridian, MS
National Provider Identifier
1558617811
Registry record updated Jul 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
1415 College Dr
Meridian, MS 39307-5345
Phone
(601) 483-4821
NPI assigned
Jul 24, 2012
Last updated
Jul 24, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

1415 College Dr
Meridian, MS 39307-5345

Mailing address

1415 College Dr
Meridian, MS 39307-5345
Phone (601) 483-4821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251105001015 MS Practitioner - Mental Health Counselor 0547750960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1415 College Dr
Meridian, MS 39307-5345

PO Box
Suite 2868
Meridian, MS 39302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Region Ten Commission State of Ms CurrentSince Aug 14, 2025 Accepting new patients

Locations

1415 College Dr
Meridian, MS 39307
Phone (601) 483-4821

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343088000000",
    "number": "1558617811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 COLLEGE DR",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393075345",
            "telephone_number": "601-483-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 COLLEGE DR",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393075345",
            "telephone_number": "601-483-4821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDGEWAY",
        "first_name": "LAQUITHA",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-24",
        "last_updated": "2012-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.