Tashi Ridley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

080032 Issued in NY

Practice address

725 Riverside Dr
Apartment 4C
New York, NY 10031-2450

Phone

(646) 263-4807

NPI assigned

Oct 29, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 22, 2024 through Mar 22, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Illumine Counseling LCSW PLLC

  • Clinical Social Worker
  • New York, NY
  • NPI 1639875511
  NPD Authorized official

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

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1679978985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 RIVERSIDE DR",
            "address_2": "APARTMENT 4C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100312450",
            "telephone_number": "646-263-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 RIVERSIDE DR",
            "address_2": "APARTMENT 4C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100312450",
            "telephone_number": "646-263-4807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDLEY",
        "first_name": "TASHI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-29",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "080032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Ridgeway
• Ridgewood Dialysis Center, Inc
• Megan Lola Ridley-Lane, M.D.
• Jazavia Ridley
• Shamika J Ridley
• Megan Ridner, PT, DPT
• Red Erickson Deynata Ridon, RPT
• Fourat Ridouani
• Ridwan Shabsigh MD PC
• Jonathan Max Rieber, MD

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.