Provider Demographics
NPI:1447249685
Name:RITTER, SANDRA H (PHD, LPC, LCMHC)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:H
Last Name:RITTER
Suffix:
Gender:F
Credentials:PHD, LPC, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4411 E CHANDLER BLVD APT 1128
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-7667
Mailing Address - Country:US
Mailing Address - Phone:704-496-3651
Mailing Address - Fax:704-793-1098
Practice Address - Street 1:4411 E CHANDLER BLVD APT 1128
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-7667
Practice Address - Country:US
Practice Address - Phone:704-496-3651
Practice Address - Fax:928-438-0107
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-20
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ-LPC17442101YP2500X
AZ17442101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC137H4OtherBLUE CROSS
NC6102177Medicaid