| Mr Andre Riddick Sr, LPCC | |
|
1301 Winchester Rd Ste 147, Lexington, KY 40505-4179 | |
| (859) 991-0710 | |
| (859) 309-1791 |
| Full Name | Mr Andre Riddick Sr |
|---|---|
| Gender | Male |
| Speciality | Counselor |
| Location | 1301 Winchester Rd Ste 147, Lexington, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003372905 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 288964 (Kentucky) | Primary |
| Entity Name | Ljks |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1194207910 PECOS PAC ID: 2769895374 Enrollment ID: O20201228001708 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Andre Riddick Sr, LPCC 1301 Winchester Rd Ste 147, Lexington, KY 40505-4179 Ph: (859) 991-0710 | Mr Andre Riddick Sr, LPCC 1301 Winchester Rd Ste 147, Lexington, KY 40505-4179 Ph: (859) 991-0710 |
Sarah E Ford, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1351 Newtown Pike, Lexington, KY 40511 Phone: 859-253-1686 | |
Michael S Stratton, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1351 Newtown Pike, Lexington, KY 40511 Phone: 859-253-1686 | |
Martin Bennett Hundley, LPCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 274 Southland Dr # 204, Lexington, KY 40503 Phone: 859-278-3456 | |
Tiffany Morgan Johnson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1351 Newtown Pike Bldg 1, Lexington, KY 40511 Phone: 589-253-1686 | |
Teonna Wilson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1351 Newtown Pike, Lexington, KY 40511 Phone: 859-253-1686 | |
Natalie Dev, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1351 Newtown Pike Bldg 5, Lexington, KY 40511 Phone: 859-253-1686 |