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

Michael Allison Ridge, LCSW

Individual provider Clinical Social Worker · NPI 1114699048

Michael Allison Ridge, LCSW is a Clinical Social Worker in Fairfax, Virginia. Qualified in 2012, 14 years ago. Practices with Northern Virginia Older Adult Counseling, a 20-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Virginia.

Years since qualifying
14
Licensed in
VA
In the registry since
2021
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

10615 Judicial Dr Ste 301
Fairfax, VA 22030-7501
Phone: (703) 667-0752
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 0904009175 (VA)

Record details

NPI number1114699048
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedSeptember 29, 2021
Last updated in NPPESSeptember 29, 2021
Certification dateSeptember 29, 2021

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Northern Virginia Older Adult Counseling — 20 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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