Provider Demographics
NPI:1760491252
Name:RYDER, LYNDA C (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:C
Last Name:RYDER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MRS
Other - First Name:LYNDA
Other - Middle Name:C
Other - Last Name:MCPHERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:40 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-1736
Mailing Address - Country:US
Mailing Address - Phone:401-433-0265
Mailing Address - Fax:
Practice Address - Street 1:70 MINNESOTA AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-6011
Practice Address - Country:US
Practice Address - Phone:401-738-0685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00164101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI26496-9OtherBLUE CROSS
RI410083OtherBLUE CHIP
RILM47193Medicaid