Individual
BEVERLY RIDINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1 TRILLIUM WAY, CORBIN, KY 40701-8426
(606) 523-8521
Mailing address
1 TRILLIUM WAY, CORBIN, KY 40701-8426
(606) 523-8521
(606) 523-8742
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
646
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100278460
—
KY
01
—
K154091
MEDICARE
KY
01
—
P01458972
RR MEDICARE
KY
Enumeration date
04/24/2007
Last updated
03/14/2024
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