Randall J. Rider, MS, LSW, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

35000981A Issued in IN

Practice address

4235 Flagstaff Cove
Fort Wayne, IN 46815-4418

Phone

(260) 969-6600

NPI assigned

Mar 13, 2007

Sex

Male

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Bridges Emotional Wellness Clinic, Inc

  • Clinical Social Worker
  • Fort Wayne, IN
  • NPI 1437375888

  Marriage & Family Therapist

  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982737722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 MAXIM DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468156130",
            "telephone_number": "260-312-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 FLAGSTAFF COVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468154418",
            "telephone_number": "260-969-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDER",
        "first_name": "RANDALL",
        "middle_name": "J.",
        "credential": "MS, LSW, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35000981A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elgerene Monique Ridderheim, NP
• Courtney N Riddle
• Robin Lee Ann Riddle, NP
• Ride Express 1
• Gregory Ridenour
• Jada Ayanna Ridley
• Andrew William Riebe, DVM
• Benjamin Riebesel
• Courtney Riecken
• Lindsay E Riegle, M. D.

• Marriage & Family Therapist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Marriage & Family Therapist in Indiana

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.