Provider Demographics
NPI:1639692742
Name:RIDGE, HEATHER CHRISTIE (LCMHC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:CHRISTIE
Last Name:RIDGE
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 PARIS MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-3524
Mailing Address - Country:US
Mailing Address - Phone:828-435-0943
Mailing Address - Fax:
Practice Address - Street 1:206 PARIS MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-3524
Practice Address - Country:US
Practice Address - Phone:828-435-0943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-20
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23491101YA0400X
NC12873101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health