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Organization
MATRIX BEHAVIORAL HEALTH PRACTICE LLC
Active
Organization
MATRIX BEHAVIORAL HEALTH PRACTICE LLC
Active
Other names
Matrix Behavioral Health Practice LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENDA LEONA RIDGEWAY PHD, LSATP (CEO/CLINICAL PRACTITIONER)
(803) 260-9897
Entity
Organization
Contact information
Practice address
210 S BRADDOCK ST, WINCHESTER, VA 22601-4090
(703) 853-0959
Mailing address
12137 DOGWOOD LN, CULPEPER, VA 22701-1352
(803) 260-9897
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
525
KS
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
NULL
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
Other
Enumeration date
04/26/2018
Last updated
07/08/2021
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