Provider Demographics
NPI:1639519218
Name:RIDENOUR, JULIA MARIE (LPC, LPA)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:MARIE
Last Name:RIDENOUR
Suffix:
Gender:F
Credentials:LPC, LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75021-3023
Mailing Address - Country:US
Mailing Address - Phone:903-818-3755
Mailing Address - Fax:
Practice Address - Street 1:600 E TAYLOR ST STE 4011
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2866
Practice Address - Country:US
Practice Address - Phone:903-893-0298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66832101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health