Healthcare Provider Details

I. General information

NPI: 1922214956
Provider Name (Legal Business Name): RIDGE OUTPATIENT COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 RIO DOSA DR
LEXINGTON KY
40509-1540
US

IV. Provider business mailing address

3050 RIO DOSA DR
LEXINGTON KY
40509-1540
US

V. Phone/Fax

Practice location:
  • Phone: 859-269-2325
  • Fax: 859-268-6472
Mailing address:
  • Phone: 859-269-2325
  • Fax: 859-268-6472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number100534
License Number StateKY
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. TERRI W HANCOCK
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 859-268-6455