JONATHAN MICHAEL RIDENOUR


Address: 2010 Sybil Ln, Tyler, TX 75703-1823
Phone: 9035368118

JONATHAN MICHAEL RIDENOUR (NPI# 1760703003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1760703003
Entity Type Individual
Full Name JONATHAN MICHAEL RIDENOUR
Credential PSYD
Practice Address 2010 Sybil Ln
Tyler
TX 75703-1823
Practice Telephone 9035368118
Practice Fax Number 9035968125
Mailing Telephone 9035368118
Mailing Fax Number 9035968125
Enumeration Date 2010-06-22
Last Update Date 2011-10-19
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103T00000X Psychologist 34806 TX Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
TEXAS LICENSE 34806 01

Other Providers JONATHAN RIDENOUR

NPI Name Taxonomy Address Enumeration
1053845776 Jonathan R Ridenour Physician Assistant 2105 E South Blvd, Montgomery, AL 36116-2409 2017-04-19

Office Location

Street Address 2010 SYBIL LN
City TYLER
State TX
Zip Code 75703-1823

Providers in the same location

NPI Name Taxonomy Address Enumeration
1659389617 Thomas Wilson Renfroe Jr. Psychologist 2010 Sybil Ln, Tyler, TX 75703-1818 2006-08-04
1396252136 Joy Leandra Neal Social Worker 2010 Sybil Ln, Tyler, TX 75703-1823 2018-01-02
1619480209 Tamra R. Howell Counselor 2010 Sybil Ln, Tyler, TX 75703-1823 2017-11-06
1174998488 Melinda Gay Counselor 2010 Sybil Ln, Suite 130, Tyler, TX 75703-1823 2015-12-11
1588061923 Psychology Associates of East Texas, LLC. Counselor 2010 Sybil Ln, Tyler, TX 75703-1823 2014-12-01
1225202773 Susan S Oravetz Counselor 2010 Sybil Ln, Tyler, TX 75703-1823 2008-04-16
1285769216 Tyler Psychology Group LLP Counselor 2010 Sybil Ln, Tyler, TX 75703-1818 2007-02-22
1700929163 Rhonda Mckinzie Counselor 2010 Sybil Ln, Tyler, TX 75703-1818 2007-02-15
1497803076 Ann O Jarrel Social Worker 2010 Sybil Ln, Tyler, TX 75703-1818 2007-01-08
1487662664 Jan Maedgen Walker Counselor 2010 Sybil Ln, Tyler, TX 75703-1818 2006-08-04
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1174155477 Choice Supportive Care Team Inc. Family Medicine 4293 Kinsey Drive, Tyler, TX 75703 2020-02-05
1770052532 Refinery Chiropractic LLC Chiropractor 16637 Old Jacksonville Hwy, Suite D, Tyler, TX 75703 2018-11-21
1215419353 Deidre Lynn Fergason Occupational Therapy Assistant 3505 Old Jacksonville Hwy, Tyler, TX 75703 2018-09-05
1710473681 Justin Taylor Ross Dentist 8938 S Broadway Ave Ste 380, Tyler, TX 75703 2018-07-03
1457843450 Adam Tyler Barnes, Dds of Texas II, Pllc Dentist 8938 South Broadway, Ste 480, Tyler, TX 75703 2018-06-05
1083106462 Integrity Health Internal Medicine 5605 Old Bullard Rd Ste B, Tyler, TX 75703 2018-06-01
1427572544 Cody Wayne Graham Pharmacist 5415 S. Broadway Ave., Tyler, TX 75703 2017-07-31
1750805941 Roger Bryan Chapman Nurse Practitioner 6115 New Copeland Rd, Tyler, TX 75703 2017-07-28
1427570084 Darah Lynne Dahlem Speech-Language Pathologist 401 E. Front Street Ste 123, Tyler, TX 75703 2017-07-14
1194267468 Herman Lester Hampton Jr. Surgery 5803 Regents Row, Tyler, TX 75703 2016-11-17
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Taxonomy Information

Taxonomy Code 103T00000X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist

Taxonomy Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Notes: Source: American Psychological Association [1/1/2007: modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1699233403 Jonathan Ridenour, Pa Psychologist 4801 Troup Hwy Ste 502, Tyler, TX 75703-2357 2019-03-11
1932326840 Robert Jerald Shore Psychologist 804 Spring Creek Dr, Tyler, TX 75703-3537 2007-04-20
1982716189 Erick R. Lenert Psychologist 1121 E Southeast Loop 323, Ste. 204, Tyler, TX 75701-9660 2006-08-31
1659389617 Thomas Wilson Renfroe Jr. Psychologist 2010 Sybil Ln, Tyler, TX 75703-1818 2006-08-04
1033127279 Sandra Harper Psychologist 2010 Sybil Ln Ste 100, Tyler, TX 75703 2006-08-03
1609404912 Trenesha Hill Psychologist 11937 Us Highway 271, Tyler, TX 75708-3154 2020-03-31
1952935389 Joseph Jacob Whitehouse Psychologist 11937 Us Highway 271, Tyler, TX 75708-3154 2020-02-25
1598306581 Ron L. Roberts, M.s., P.C. Psychologist 1121 E Southeast Loop 323 Ste 204, Tyler, TX 75701-9660 2019-10-01
1578044384 Sandra Harper Pllc Psychologist 2010 Sybil Ln Ste 100, Tyler, TX 75703-1817 2018-08-29
1477049252 Sandy Harper PC Psychologist 2010 Sybil Ln Ste 100, Tyler, TX 75703-1817 2018-07-05
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Competitor

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City TYLER
Zip Code 75703

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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