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Individual
MR. JOHN B RIDGEWAY
Active
Individual
MR. JOHN B RIDGEWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LLP LMSW CAAC SAP
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAC-I,SAP
MI
103TC0700X
Clinical Psychologist
6301003780
MI
1041C0700X
Clinical Social Worker
Primary
6801013086
MI
Other
Enumeration date
07/03/2006
Last updated
07/10/2013
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