MEDICARE: ERIC PETER RYDZEWSKI

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
1	101YM0800X	Mental Health Counselor	0018052	CO

General Provider Information

NPI Number	:	1083073985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC PETER RYDZEWSKI

Provider Business Mailing Address
First Line	:	2784 CROSSROADS BLVD
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81506-8711
Country	:	US
Telephone Number	:	570-780-7703
Fax Number	:

Provider Business Practice Location Address
First Line	:	2784 CROSSROADS BLVD
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81506-8711
Country	:	US
Telephone Number	:	570-780-7703
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2016
Last Update Date	:	02/18/2026

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