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MR. ANDRE RIDDICK SR. LPCC
NPI 1003372905
Counselor in Lexington, KY

Active since February 15, 2019PECOS Enrolled
1301 WINCHESTER RD STE 147, LEXINGTON, KY 40505(859) 991-0710(859) 309-1791 Get Directions Write a Review

NPPES record last updated: November 28, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mr. Andre Riddick Sr. Lpcc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. ANDRE RIDDICK SR. LPCC (NPI 1003372905) is an individual counselor in Lexington, Kentucky, licensed in Kentucky (288964) and active in the NPI registry since February 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1003372905
Entity TypeIndividualMale
Primary Taxonomy101Y00000X
Provider Legal NameMR. ANDRE RIDDICK SR.Credential: LPCC
Location Address1301 WINCHESTER RD STE 147Lexington, KY 40505-4179
Mailing Address1301 Winchester Rd Ste 147Lexington, KY 40505-4179 · (859) 991-0710 · Fax (859) 309-1791
Phone(859) 991-0710
Fax(859) 309-1791
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateFebruary 15, 2019
Last NPPES UpdateNovember 28, 2023
NPPES CertifiedNovember 28, 2023
✔ NPI 1003372905 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License✔ Licensed in KY · 288964
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
1301 WINCHESTER RD STE 147, Lexington, KY 40505
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Andre Riddick Sr. Lpcc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5799126918
PECOS Enrollment IDI20240517002960
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Andre Riddick reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ljks
Same address
Professional
1301 WINCHESTER RD STE 147
Lexington, KY 40505
  • Reassigned Medicare billing, Kentucky enrollment
  • 7 clinicians in this Medicare group
NPI 1194207910 (859) 309-2814

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LJKS
Counselor (Professional)
1301 WINCHESTER RD STE 147
LEXINGTON, KY 40505
Fayette County (859) 309-2814
TONIA ANN WELLS LCSW
Social Worker (Clinical)
1301 WINCHESTER RD STE 147
LEXINGTON, KY 40505
Fayette County (859) 309-2814
ANDREE DEIFEL NP-C
Nurse Practitioner
1301 WINCHESTER RD STE 147
LEXINGTON, KY 40505
Fayette County (859) 309-2814

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Andre Riddick's NPI number?

The NPI number for Andre Riddick is 1003372905. It was assigned to this individual provider in the NPPES registry on February 15, 2019.

Where is Andre Riddick located?

Andre Riddick practices at 1301 Winchester Rd Ste 147, Lexington, KY 40505. The listed phone number is (859) 991-0710.

What is Andre Riddick's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Andre Riddick enrolled in Medicare?

Yes. Andre Riddick is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Andre Riddick's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Andre Riddick reassigns Medicare benefits to Ljks (Lexington, KY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Andre Riddick's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Andre Riddick accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee and Anthem Blue Cross and Blue Shield list Andre Riddick as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Andre Riddick was last updated on November 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.