Provider Demographics
NPI:1134833346
Name:RIDGELINE COUNSELING AND SUPERVISION PLLC
Entity type:Organization
Organization Name:RIDGELINE COUNSELING AND SUPERVISION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:904-803-3350
Mailing Address - Street 1:4052 ANCESTRY CIR
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-7601
Mailing Address - Country:US
Mailing Address - Phone:904-803-3350
Mailing Address - Fax:
Practice Address - Street 1:4052 ANCESTRY CIR
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28104-7601
Practice Address - Country:US
Practice Address - Phone:904-803-3350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty