Individual provider Active NPI

Mary Catherine Ridenour, LPC-MHSP

  • Mental Health Counselor
  • Knoxville, TN
National Provider Identifier
1679810063
Registry record updated Aug 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4544 Issued in TN
Practice address
408 N Cedar Bluff Rd # 305
Knoxville, TN 37923-3607
Phone
(865) 325-2085
NPI assigned
Jan 7, 2013
Last updated
Aug 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Mental Health Counselor 101YM0800X 4544 TN Primary

Addresses

Primary practice location

408 N Cedar Bluff Rd # 305
Knoxville, TN 37923-3607

Mailing address

1240 E Moody Ave
Knoxville, TN 37920-2540
Phone (865) 603-2555

Other practice location 1

201 W Springdale Ave
Knoxville, TN 37917-5158
Phone (865) 637-9711

Other practice location 2

687 Morganton Square Dr
Maryville, TN 37801-4763
Phone (865) 685-5270

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
4544TNMDMental Health Counselor

Interoperability endpoints

  • Direct secure messaging: mary.ridenour.1@20785.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1679810063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 E MOODY AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379202540",
            "telephone_number": "865-603-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 N CEDAR BLUFF RD # 305",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379233607",
            "telephone_number": "865-325-2085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 W Springdale Ave",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379175158",
            "country_code": "US",
            "telephone_number": "865-637-9711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "687 Morganton Square Dr",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "TN",
            "postal_code": "378014763",
            "country_code": "US",
            "telephone_number": "865-685-5270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDENOUR",
        "first_name": "MARY",
        "middle_name": "CATHERINE",
        "credential": "LPC-MHSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-07",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "4544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.