RANDALL J. RIDER (NPI# 1982737722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982737722 |
| Entity Type | Individual |
| Full Name | RANDALL J. RIDER |
| Credential | MS, LSW, LMFT |
| Practice Address |
4235 Flagstaff Cove Fort Wayne IN 46815-4418 |
| Mailing Address |
3535 Maxim Dr Fort Wayne IN 46815-6130 |
| Practice Telephone | 2609696600 |
| Mailing Telephone | 2603120904 |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 35000981A | IN | Behavioral Health & Social Service Providers |
| Street Address |
4235 FLAGSTAFF COVE |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46815-4418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255346011 | Agnes Cecilia Osterholt-polston | Social Worker | 4235 Flagstaff Cove, Fort Wayne, IN 46815 | 2006-07-30 |
| 1437375888 | Bridges Emotional Wellness Clinic, Inc | Marriage & Family Therapist | 4235 Flagstaff Cove, Fort Wayne, IN 46815-4418 | 2007-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306305438 | Sullivan Services, Inc. | In Home Supportive Care | 2789-b Maplecrest Rd, Fort Wayne, IN 46815 | 2019-03-18 |
| 1598250144 | Altermease Gleason | Massage Therapist | 3406 Thames Drive, Fort Wayne, IN 46815 | 2018-06-26 |
| 1881000222 | Denise Sparks | Specialist | 6415 Benham Drive, Fort Wayne, IN 46815 | 2014-07-07 |
| 1962823138 | Chad Distelrath | Physical Therapy Assistant | 1717 Maplecrest Rd, Apt 112, Fort Wayne, IN 46815 | 2013-12-13 |
| 1689943409 | Kendall Joan Labrash | Physical Therapist | 4251 Lahmeyer Rd., Fort Wayne, IN 46815 | 2011-12-22 |
| 1801179718 | Jayson Laube | Pharmacist | 6201 Stellhorn, Fort Wayne, IN 46815 | 2011-09-27 |
| 1720294432 | Muscle Therapy Clinic LLC | Massage Therapist | 6409 Georgetown North Blvd, Fort Wayne, IN 46815 | 2007-05-16 |
| 1427186436 | Legoras Conture Fashions | Prosthetic/Orthotic Supplier | 3316 Inwood Drive, Fort Wayne, IN 46815 | 2007-03-01 |
| 1932252772 | Fort Wayne Smiles PC | Dentist | 2031 Reed Road, Fort Wayne, IN 46815 | 2007-01-18 |
| 1811078538 | Timothy Doody Lynch | Dentist | 4207 Hobson Court, Fort Wayne, IN 46815 | 2006-10-18 |
| Find all providers in zip 46815 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487287371 | Fort Wayne Counseling Services | Marriage & Family Therapist | 6319 Mutual Dr Ste F, Fort Wayne, IN 46825-4246 | 2020-02-19 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1922497775 | Mary Lisa Barta LLC | Marriage & Family Therapist | 5630 The Prophets Pass, Fort Wayne, IN 46845-9473 | 2015-01-16 |
| 1548506728 | Carmella Nicole Oneal | Marriage & Family Therapist | 4630 W Jefferson Blvd Ste 3, Fort Wayne, IN 46804-6800 | 2012-12-17 |
| 1962754523 | Matt Ryan Givens | Marriage & Family Therapist | 237 Airport North Office Park, Fort Wayne, IN 46825-6702 | 2012-10-08 |
| 1083988547 | Glenis A Sundberg | Marriage & Family Therapist | 1818 Carew St Ste 320, Fort Wayne, IN 46805-4764 | 2012-03-01 |
| 1982982898 | Ferraro Behavior Services, LLC | Marriage & Family Therapist | 9512 Lima Rd Ste 103, Fort Wayne, IN 46818-9806 | 2011-07-26 |
| 1679870646 | Stephen Michael O'shaughnessy | Marriage & Family Therapist | 3407 Rolston St, Fort Wayne, IN 46805-1535 | 2011-02-27 |
| 1760711808 | Marjorie L Havens | Marriage & Family Therapist | 2330 Beacon St, Suite 105, Fort Wayne, IN 46805-3852 | 2009-12-21 |
| 1366673956 | Melissa Ann Borton | Marriage & Family Therapist | 126 W Columbia St, Ste 300, Fort Wayne, IN 46802-1719 | 2009-07-31 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46815 |
Please comment or provide details below to improve the information on RANDALL J. RIDER.
| 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.