Provider Demographics
NPI:1164875266
Name:RIDLEY, TONYA (LPC CRC)
Entity Type:Individual
Prefix:MS
First Name:TONYA
Middle Name:
Last Name:RIDLEY
Suffix:
Gender:F
Credentials:LPC CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1929 VALLEY TER SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-4627
Mailing Address - Country:US
Mailing Address - Phone:202-768-8454
Mailing Address - Fax:
Practice Address - Street 1:1929 VALLEY TER SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4627
Practice Address - Country:US
Practice Address - Phone:202-768-8454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-13
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC14577101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor