MEDICARE: HEATHER RYDER LCMHC, MLADC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	2146	NH
2	101YM0800X	Mental Health Counselor	5713	NH

General Provider Information

NPI Number	:	1689154411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER RYDER LCMHC, MLADC

Provider Business Mailing Address
First Line	:	221 MAIN ST STE R
Second Line	:
City	:	NASHUA
State	:	NH
Zip	:	03060-2913
Country	:	US
Telephone Number	:	978-203-3590
Fax Number	:

Provider Business Practice Location Address
First Line	:	221 MAIN ST STE R
Second Line	:
City	:	NASHUA
State	:	NH
Zip	:	03060-2913
Country	:	US
Telephone Number	:	978-203-3590
Fax Number	:

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

Provider Enumeration Date	:	08/21/2018
Last Update Date	:	04/01/2026

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