MEDICARE: DENEA LOIS RIDLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	343900000X	Non-emergency Medical Transport (VAN)	OH
3	376J00000X	Homemaker	OH
4	101YM0800X	Mental Health Counselor
5	347C00000X	Private Vehicle	OH

General Provider Information

NPI Number	:	1225639610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENEA LOIS RIDLEY

Provider Business Mailing Address
First Line	:	838 CLEVELAND AVE APT 1
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45229-2879
Country	:	US
Telephone Number	:	216-600-3162
Fax Number	:

Provider Business Practice Location Address
First Line	:	1625 CALIFORNIA AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-5603
Country	:	US
Telephone Number	:	216-600-3162
Fax Number	:

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

Provider Enumeration Date	:	11/03/2020
Last Update Date	:	10/13/2025

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Directions to “ DENEA LOIS RIDLEY ” Practice Location

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