Individual provider Active NPI

Latonya Ridges, LCSW-A, LCAS

  • Clinical Social Worker
  • Fuquay Varina, NC
National Provider Identifier
1710649645
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P016816 Issued in NC
Practice address
609 Attain St Ste 101
Fuquay Varina, NC 27526-1984
Phone
(919) 567-0684
NPI assigned
Oct 7, 2021
Last updated
Oct 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P016816 NC Primary

Addresses

Primary practice location

609 Attain St Ste 101
Fuquay Varina, NC 27526-1984

Mailing address

PO Box 753
Coats, NC 27521-0753
Phone (919) 771-8900

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
P016816NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1710649645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 753",
            "city": "COATS",
            "state": "NC",
            "postal_code": "275210753",
            "telephone_number": "919-771-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 ATTAIN ST STE 101",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275261984",
            "telephone_number": "919-567-0684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDGES",
        "first_name": "LATONYA",
        "credential": "LCSW-A, LCAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-07",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P016816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fuquay Varina, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.