Individual provider Active NPI

Vanessa Ridgewell, MC, LPC

  • Professional Counselor
  • Mesa, AZ
National Provider Identifier
1629594460
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC18309 Issued in AZ
Practice address
2266 S Dobson Rd Ste 258
Mesa, AZ 85202-6488
Phone
(480) 444-8067
NPI assigned
Aug 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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 LPC18309 AZ Primary

Addresses

Primary practice location

2266 S Dobson Rd Ste 258
Mesa, AZ 85202-6488

Mailing address

2266 S Dobson Rd Ste 258
Mesa, AZ 85202-6488
Phone (480) 444-8067

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

LicenseStateTypeSpecialty
LPC18309AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Purposeful Life Counseling, LLC Professional CurrentSince Sep 20, 2020 Accepting new patients

Locations

2266 S Dobson Rd
Ste 258
Mesa, AZ 85202
Phone (480) 444-8067

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1502668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1629594460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2266 S DOBSON RD STE 258",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852026488",
            "telephone_number": "480-444-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2266 S DOBSON RD STE 258",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852026488",
            "telephone_number": "480-444-8067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDGEWELL",
        "first_name": "VANESSA",
        "credential": "MC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-14",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC18309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.