Healthcare Provider Details

I. General information

NPI: 1235515255
Provider Name (Legal Business Name): BIZU SOLOMON RIDENHOUR LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2015
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 S ST NW STE B
WASHINGTON DC
20009-6107
US

IV. Provider business mailing address

6488 SUTCLIFFE DR
ALEXANDRIA VA
22315-5578
US

V. Phone/Fax

Practice location:
  • Phone: 202-234-7738
  • Fax:
Mailing address:
  • Phone: 202-695-2930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPRC200001859
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: