Organization Active NPI

Ridley Behavioral Health

  • Clinical Psychologist
  • Cleveland HTS, OH
National Provider Identifier
1679162697
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
RIDLEY BEHAVIORAL HEALTH
Practice address
5 Severance Cir Ste 709
Cleveland HTS, OH 44118-1590
Phone
(216) 570-2798
NPI assigned
Jan 14, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Authorized official

Name
Josephine Ridley, PHDNPI 1033129994
Title
President/Owner
Phone
(216) 570-2798

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

5 Severance Cir Ste 709
Cleveland HTS, OH 44118-1590

Mailing address

PO Box 181583
Cleveland HTS, OH 44118-7583
Phone (216) 570-2798

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210215000272 OH Part B Supplier - Clinic/Group Practice 6305251869 Receives reassigned benefits from 1 practitioner
Practice locations: Lyndhurst, OH

National Provider Directory

National Provider Directory

Locations

5 Severance Cir
Ste 709
Cleveland Heights, OH 44118
Phone (216) 291-0515

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610582400000",
    "number": "1679162697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 181583",
            "city": "CLEVELAND HTS",
            "state": "OH",
            "postal_code": "441187583",
            "telephone_number": "216-570-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SEVERANCE CIR STE 709",
            "city": "CLEVELAND HTS",
            "state": "OH",
            "postal_code": "441181590",
            "telephone_number": "216-570-2798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDLEY BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-14",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A",
        "authorized_official_last_name": "RIDLEY",
        "authorized_official_first_name": "JOSEPHINE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "216-570-2798",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland HTS, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.