Provider Demographics
NPI:1619478203
Name:RIDINGS, MOLLIE ELIZABETH (LSW)
Entity Type:Individual
Prefix:
First Name:MOLLIE
Middle Name:ELIZABETH
Last Name:RIDINGS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 WOODLANDS DR
Mailing Address - Street 2:
Mailing Address - City:AMELIA
Mailing Address - State:OH
Mailing Address - Zip Code:45102-1754
Mailing Address - Country:US
Mailing Address - Phone:513-455-0059
Mailing Address - Fax:
Practice Address - Street 1:17 WOODLANDS DR
Practice Address - Street 2:
Practice Address - City:AMELIA
Practice Address - State:OH
Practice Address - Zip Code:45102-1754
Practice Address - Country:US
Practice Address - Phone:513-455-0059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1600520104100000X
OHI21031711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE