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

Kenneth Riddle III

Individual provider Professional Counselor · NPI 1962074203

Kenneth Riddle III is a Mental Health Counselor in Canonsburg, Pennsylvania. Qualified in 2012, 14 years ago. Practices with Mls Mindful Therapy PC, a 4-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
14
Licensed in
PA
In the registry since
2021
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Practice location Address checks out

135 Technology Dr Ste 312
Canonsburg, PA 15317-9549
Phone: (724) 413-4306
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence PC007823 (PA)

Record details

NPI number1962074203
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 15, 2021
Last updated in NPPESJanuary 30, 2024
Certification dateJanuary 30, 2024
Mailing address135 Technology Dr Ste 312, Canonsburg, PA 15317-9549

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Mls Mindful Therapy Pc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Canonsburg