Traci Kristine Riddle, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2259 Issued in OK

Practice address

4009 Eufaula Ave
Muskogee, OK 74403-1132

Phone

(918) 682-2841

Fax

(918) 686-6859

NPI assigned

Oct 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1994

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Green Country Behavioral Health Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Muskogee, OK
  • NPI 1336203132
  Medicare reassignment NPD
• Muskogee County Council of Youth Service

  • Community/Behavioral Health Agency
  • Muskogee, OK
  • NPI 1215173133
  NPD (past) Authorized official
• Muskogee County Council of Youth Services

  • Community/Behavioral Health Agency
  • Muskogee, OK
  • NPI 1639251457
  NPD (past) Authorized official

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891877619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 CARY PL",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744038581",
            "telephone_number": "918-686-7987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 EUFAULA AVE",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744031132",
            "telephone_number": "918-682-2841",
            "fax_number": "918-686-6859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDDLE",
        "first_name": "TRACI",
        "middle_name": "KRISTINE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "2259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darren Eugene Richison
• Julie Richter
• Margaret M Richter, DPH
• Terri Lynn Rickerson, MSN RN, AGPCNP-BC
• Destiny Riddle
• Jillian Ross Riley, DO
• Melani Riley, R.D.
• Michael D Riley, MD
• Randi Riley
• Teresa S Riley

• Professional Counselor in Muskogee, OK
• Providers in Muskogee, OK by specialty
• Professional Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.