Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jonathan Michael Ridenour, PSYD

Individual provider Psychologist · NPI 1760703003

Dr. Jonathan Michael Ridenour, PSYD is a Clinical Psychologist in Tyler, Texas. Qualified in 2011, 15 years ago. Accepts Medicare assignment and offers telehealth. Licensed in Texas.

Years since qualifying
15
Licensed in
TX
In the registry since
2010
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

4801 Troup Hwy Ste 502
Tyler, TX 75703-2357
Phone: (903) 630-5788
Fax: (903) 630-5885
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence 34806 (TX)

Record details

NPI number1760703003
Entity typeIndividual (Type 1)
GenderMale
Credentials PSYD
Sole proprietorNo
NPI enumeratedJune 22, 2010
Last updated in NPPESSeptember 18, 2023
Certification dateSeptember 18, 2023
Mailing address4801 Troup Hwy Ste 502, Tyler, TX 75703-2357

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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