JACOB ISRAEL RYDER LPC NPI 1104504794

NPI Information

  • NPI: 1104504794
  • Provider Name: JACOB ISRAEL RYDER, LPC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 200 MEDICAL DR
    HAMPTON, VA
    ZIP 23666
  • Phone: (757) 788-0200

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NPI Details

Jacob Israel Ryder, LPC is a professional counselor in Hampton, VA. Jacob Israel Ryder, LPC NPI is 1104504794. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

200 MEDICAL DR
HAMPTON, VA
ZIP 23666-763
Phone: (757) 788-0200

The NPI 1104504794 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 7/5/2023 and was last updated on 7/5/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YP2500XCounselorProfessional0701012308VIRGINIAYes
2101YA0400XCounselorAddiction (Substance Use Disorder)0710103463VIRGINIANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10710103463OTHERVIRGINIACSAC
20701012308OTHERVIRGINIALICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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