Basic Information
| Provider Information | |||||||||
| NPI: | 1437689742 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RIDGELINE THERAPEUTIC COLLABORATIVE, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 133 E PALMER ST STE 101 | ||||||||
| Address2: | |||||||||
| City: | FRANKLIN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287343036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8283710522 | ||||||||
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| Practice Location | |||||||||
| Address1: | 53 E MAIN ST STE C | ||||||||
| Address2: | |||||||||
| City: | FRANKLIN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287343019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8283470522 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | SNYDER | ||||||||
| AuthorizedOfficialFirstName: | AUDREY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CO-OWNER/MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 8283470522 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 09/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | C008820 | NC | N | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP2500X | A11875 | NC | N | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional | 101YM0800X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.