Healthcare Provider Details

I. General information

NPI: 1760491252
Provider Name (Legal Business Name): LYNDA C RYDER LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYNDA C MCPHERSON LMHC

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 MINNESOTA AVE
WARWICK RI
02888-6011
US

IV. Provider business mailing address

40 FOREST AVE
RIVERSIDE RI
02915-1736
US

V. Phone/Fax

Practice location:
  • Phone: 401-738-0685
  • Fax:
Mailing address:
  • Phone: 401-433-0265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC00164
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: