DR. CHARLES ROBERT RIDLEY (NPI# 1386010676) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386010676 |
| Entity Type | Individual |
| Full Name | DR. CHARLES ROBERT RIDLEY |
| Credential | PH.D. |
| Practice Address |
3201 University Dr E Suite 200 Bryan TX 77802-3475 |
| Practice Telephone | 8123401714 |
| Mailing Telephone | 8123401714 |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2015-08-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | PSY9586 | CA | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | 20041066A | IN | Behavioral Health & Social Service Providers |
| Y | 103T00000X | Psychologist | 37060 | TX | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992718175 | Charles L Ridley IIi | Internal Medicine | 2266 Ingleside Ave, Macon, GA 31204-2032 | 2006-08-15 |
| 1518242114 | Charles Fred Ridley | Social Worker | 1031 Ives Dairy Rd, Suite 228, Miami, FL 33179-2538 | 2011-10-14 |
| Street Address |
3201 UNIVERSITY DR E SUITE 200 |
| City | BRYAN |
| State | TX |
| Zip Code | 77802-3475 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508863564 | Choice Health Services, Inc. | Home Health | 3201 University Dr E, Suite 475, Bryan, TX 77802-3475 | 2005-07-06 |
| 1447877345 | Bcs Eye Associates, Inc. | Ophthalmology | 3201 University Dr E, Bryan, TX 77802-3475 | 2020-06-26 |
| 1316562408 | Vicki Hoang Nhung Nguyen | Optometrist | 3201 University Dr E, Bryan, TX 77802-3475 | 2020-06-15 |
| 1851830111 | Mtr Treatment Corp | Substance Abuse Rehabilitation Facility | 3201 University Dr E, Suite 230, Bryan, TX 77802-3475 | 2017-02-20 |
| 1285082768 | Dcs Medical Pa | Clinic/Center | 3201 University Dr E, Suite 135, Bryan, TX 77802-3475 | 2016-05-25 |
| 1578921391 | Gretchen S. Noble, Psyd, Pllc | Clinic/Center | 3201 University Dr E, Suite 200, Bryan, TX 77802-3475 | 2016-02-08 |
| 1982079315 | Keri Leigh Moon | Physician Assistant | 3201 University Dr E, Ste 245, Bryan, TX 77802-3483 | 2015-12-10 |
| 1366813958 | Cynthia Shannon, Lmft, Pllc | Marriage & Family Therapist | 3201 University Dr E, Ste 200, Bryan, TX 77802-3475 | 2015-10-08 |
| 1972970531 | Brooke Martin Lpc Pllc | Community/Behavioral Health | 3201 University Dr E, Suite 200, Bryan, TX 77802-3475 | 2015-08-29 |
| 1003206285 | L Justin Gayle Md Pllc | Obstetrics & Gynecology | 3201 University Dr E, Ste 370, Bryan, TX 77802-3475 | 2015-01-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013476951 | Andrea Pittman | Student in an Organized Health Care Education/Training Program | Primary Care Medicine Department, College of Medicine, 2900 East 29th Street, Bryan, TX 77802 | 2019-03-19 |
| 1942789110 | Alicia Diane Ates | Dentist | 3001 Wildflower Drive, Suite #511, Bryan, TX 77802 | 2018-08-09 |
| 1588151682 | Metx LLC | Audiologist-Hearing Aid Fitter | 3030 E 29th St Ste 102, Bryan, TX 77802 | 2018-04-16 |
| 1073047437 | Abbi Messer | Family Medicine | 2900 29th Street, Suite 100, Bryan, TX 77802 | 2017-04-12 |
| 1265885180 | Scott Andrew Thayer | Dentist | 3811 Stoneparc Dr, Bryan, TX 77802 | 2016-07-15 |
| 1255792123 | Phoebe Mathew | Pharmacist | 3312 East 29th Street, Bryan, TX 77802 | 2016-03-18 |
| 1801253810 | Pearl Coleshill | Specialist/Technologist | 3121 University Drive E., Suite 100, Bryan, TX 77802 | 2016-01-21 |
| 1265847750 | Wesley Danielle Daniels | Dietitian, Registered | 3900-c Carter Creek Pkway, Bryan, TX 77802 | 2014-06-24 |
| 1235549098 | Regina V. Robertson | Home Health | 1121 Briarcrest Dr., Suite 102, Bryan, TX 77802 | 2014-05-02 |
| 1982024238 | Lampstand Nursing and Rehabilitation, Lp | Skilled Nursing Facility | 2001 E 29th Street, Bryan, TX 77802 | 2014-04-24 |
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| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558982298 | Kaylee Jackson | Psychologist | 8441 Hwy 47, St 1100, Bryan, TX 77807 | 2020-05-05 |
| 1457972192 | Melina Renee Cavazos | Psychologist | 8441 Highway 47, Clinical Building 1, Suite 1100, Bryan, TX 77807 | 2020-05-05 |
| 1003468182 | Ryan Frank Pittsinger | Psychologist | 211 N Main St Apt 23, Bryan, TX 77803-3277 | 2019-07-10 |
| 1891202917 | Kim Villabona, Psy.d | Psychologist | 405 E 31st St, Bryan, TX 77803-7027 | 2018-01-10 |
| 1235592296 | Lamb Behavioral Health Center LLC | Psychologist | 1737 Briarcrest Dr Ste 24, Bryan, TX 77802-2769 | 2016-03-29 |
| 1720413321 | Jun-chih Gisela Lin | Psychologist | 1401 Sandia Plz, Bryan, TX 77802-4356 | 2013-09-13 |
| 1639458284 | Kim Villabona | Psychologist | 2908 Woodmeadow Dr, Bryan, TX 77802-4769 | 2011-08-15 |
| 1699805929 | Bradley Douglas Powell | Psychologist | 2400 Broadmoor Dr Ste C, Bryan, TX 77802-2870 | 2007-03-06 |
| 1831295864 | Kim Marie Arredondo | Psychologist | 704 E 29th St Ste B, Bryan, TX 77803-4898 | 2006-09-16 |
| 1073618062 | Nancy E Algert | Psychologist | 115 Royal Street, Bryan, TX 77801 | 2006-09-14 |
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| 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.