Provider Demographics
NPI:1881705465
Name:RITZ, LYNNEA JANE (LICSW)
Entity type:Individual
Prefix:MS
First Name:LYNNEA
Middle Name:JANE
Last Name:RITZ
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4023 STATE ST STE 120
Mailing Address - Street 2:SUITE 120
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0690
Mailing Address - Country:US
Mailing Address - Phone:701-751-4447
Mailing Address - Fax:701-751-4471
Practice Address - Street 1:4023 STATE ST STE 120
Practice Address - Street 2:SUITE 120
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0690
Practice Address - Country:US
Practice Address - Phone:701-751-4447
Practice Address - Fax:701-751-4471
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND28991041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND26441OtherBLUE CROSS/BLUE SHIELD OF
NDHP65336OtherHEALTHPARTNERS/EAP
ND268548OtherCOMPSYCH/EAP
26441OtherBCBS
ND19160Medicaid
ND19147Medicaid
ND19147Medicaid
ND26441OtherBLUE CROSS/BLUE SHIELD OF
ND711826Medicare ID - Type UnspecifiedGROUP NUMBER