MATRIX BEHAVIORAL HEALTH PRACTICE LLC NPI 1194213918

NPI Information

  • NPI: 1194213918
  • Provider Name: MATRIX BEHAVIORAL HEALTH PRACTICE LLC
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Organization
  • Doing Business As: MATRIX BEHAVIORAL HEALTH PRACTICE LLC
  • Address: 210 S BRADDOCK ST
    WINCHESTER, VA
    ZIP 22601
  • Phone: (703) 853-0959

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NPI Details

MATRIX BEHAVIORAL HEALTH PRACTICE LLC is an addiction (substance use disorder) counselor in Winchester, VA. MATRIX BEHAVIORAL HEALTH PRACTICE LLC NPI is 1194213918. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Matrix Behavioral Health Practice Llc.

The provider's business location address is:

210 S BRADDOCK ST
WINCHESTER, VA
ZIP 22601-090
Phone: (703) 853-0959

The provider's authorized official is Brenda Leona Ridgeway .
The authorized official title is Ceo/clinical Practitioner and has the following contact phone number (803) 260-9897.

The enumeration date for this NPI number is 4/26/2018 and was last updated on 7/8/2021.

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
1101YA0400XCounselorAddiction (Substance Use Disorder)525KANSASYes
2103TA0400XPsychologistAddiction (Substance Use Disorder)No

What is NPI?

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This page was last updated on: 3/30/2025

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