Active NPI
Mary Catherine Ridenour, LPC-MHSP
- Mental Health Counselor
- Knoxville, TN
National Provider Identifier
1679810063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 4544
- 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, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 4544 | TN | MD | Mental Health Counselor |
Interoperability endpoints
- 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.