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NPI Code Detail

MEDICARE: MS. DEBORAH KAY RIDGEWAY

MEDICARE: MS. DEBORAH KAY RIDGEWAY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041S0200XSchool Social WorkerM-06358NM
2171M00000XCase Manager/Care Coordinator
31041C0700XClinical Social WorkerC-12070NM
4104100000XSocial Worker
51041C0700XClinical Social WorkerCSW.09925245CO

General Provider Information

NPI Number : 1578611091
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DEBORAH KAY RIDGEWAY
Provider Business Mailing Address
First Line : 2350 PARK PLACE DR APT 199
Second Line :
City : GRETNA
State : LA
Zip : 70056-3077
Country : US
Telephone Number : 505-440-8674
Fax Number :
Provider Business Practice Location Address
First Line : 2626 CHARLES DR
Second Line :
City : CHALMETTE
State : LA
Zip : 70043-3779
Country : US
Telephone Number : 504-278-4006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2007
Last Update Date : 01/08/2024

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