Provider Demographics
NPI:1265198600
Name:RIDEOUT, CHRISTY ANN
Entity type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:ANN
Last Name:RIDEOUT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 STRICKLAND RD STE 107
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3189
Mailing Address - Country:US
Mailing Address - Phone:919-569-5820
Mailing Address - Fax:
Practice Address - Street 1:7901 STRICKLAND RD STE 107
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3189
Practice Address - Country:US
Practice Address - Phone:919-569-5820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-10
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01687106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist