Active NPI
Eugene H. Ridberg, PH.D
- Clinical Psychologist
- Kensington, MD
National Provider Identifier
1770732133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 00666
- Practice address
- 10400 Connecticut Ave.
Suite 303
Kensington, MD 20895-3910 - Phone
- (301) 946-5180
- Fax
- (301) 942-2026
- NPI assigned
- Sep 10, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 00666 | MD | Primary |
Addresses
Primary practice location
10400 Connecticut Ave.
Suite 303
Kensington, MD 20895-3910
Mailing address
10400 Connecticut Ave.
Suite 303
Kensington, MD 20895-3910
Phone (301) 946-5180
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00666 | MD | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221004800000",
"number": "1770732133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10400 CONNECTICUT AVE.",
"address_2": "SUITE 303",
"city": "KENSINGTON",
"state": "MD",
"postal_code": "208953910",
"telephone_number": "301-946-5180",
"fax_number": "301-942-2026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10400 CONNECTICUT AVE.",
"address_2": "SUITE 303",
"city": "KENSINGTON",
"state": "MD",
"postal_code": "208953910",
"telephone_number": "301-946-5180",
"fax_number": "301-942-2026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDBERG",
"first_name": "EUGENE",
"middle_name": "H.",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-09-10",
"last_updated": "2008-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "00666",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kensington, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.