MEDICARE: BRITTANY RIDDLE LMFT

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	106H00000X	Marriage & Family Therapist	TLC.1886.MFT	SC
2	106H00000X	Marriage & Family Therapist	282792	KY
3	106H00000X	Marriage & Family Therapist	35002536A	IN

General Provider Information

NPI Number	:	1629784319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY RIDDLE LMFT

Provider Business Mailing Address
First Line	:	8009 NEW LA GRANGE RD STE 1
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40222-4791
Country	:	US
Telephone Number	:	502-726-4078
Fax Number	:

Provider Business Practice Location Address
First Line	:	8009 NEW LA GRANGE RD STE 1
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40222-4791
Country	:	US
Telephone Number	:	502-509-9307
Fax Number	:

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

Provider Enumeration Date	:	01/25/2023
Last Update Date	:	06/28/2026

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