Healthcare Provider Details

I. General information

NPI: 1780086777
Provider Name (Legal Business Name): JOSHUA RIDGEWAY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2014
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 MADISON RD
CINCINNATI OH
45227-1491
US

IV. Provider business mailing address

7005 READING RD
CINCINNATI OH
45237-3802
US

V. Phone/Fax

Practice location:
  • Phone: 513-272-2800
  • Fax: 513-631-7484
Mailing address:
  • Phone: 513-363-9317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberS.1904383
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: