| Matrix Behavioral Health Practice Llc | |
|
210 S Braddock St Winchester VA 22601-4090 | |
| (703) 853-0959 | |
| Not Available |
| Full Name | Matrix Behavioral Health Practice Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 210 S Braddock St, Winchester, Virginia |
| Authorized Official Name and Position | Brenda Leona Ridgeway (CEO/CLINICAL PRACTITIONER) |
| Authorized Official Contact | 8032609897 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Matrix Behavioral Health Practice Llc 12137 Dogwood Ln Culpeper VA 22701-1352 Ph: (803) 260-9897 | Matrix Behavioral Health Practice Llc 210 S Braddock St Winchester VA 22601-4090 Ph: (703) 853-0959 |
| NPI Number | 1194213918 |
|---|---|
| Provider Enumeration Date | 04/26/2018 |
| Last Update Date | 07/08/2021 |
| Certification Date | 07/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194213918 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 525 (Kansas) | Primary |
| 103TA0400X | Psychologist - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
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