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
—
—
Other
Enumeration date
04/26/2018
Last updated
07/08/2021
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