Provider Demographics
NPI:1518843028
Name:RIDORE, KAYITA (MA/EDS, NCC, LPC)
Entity type:Individual
Prefix:
First Name:KAYITA
Middle Name:
Last Name:RIDORE
Suffix:
Gender:F
Credentials:MA/EDS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:197 LAFAYETTE PL APT A1
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-3943
Mailing Address - Country:US
Mailing Address - Phone:914-217-5055
Mailing Address - Fax:
Practice Address - Street 1:197 LAFAYETTE PL APT A1
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-3943
Practice Address - Country:US
Practice Address - Phone:914-217-5055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC01159400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional