1982803185 NPI number — MS. JODY J RITTER CAGS, LMHC

Table of content: MS. JODY J RITTER CAGS, LMHC (NPI 1982803185)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982803185 NPI number — MS. JODY J RITTER CAGS, LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RITTER
Provider First Name:
JODY
Provider Middle Name:
J
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CAGS, LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982803185
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/03/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
207 WATERBURY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH SYRACUSE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13212-2722
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-391-3986
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
117 EDDIE DOWLING HWY UNIT LLA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH SMITHFIELD
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02896-7337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-298-3862
Provider Business Practice Location Address Fax Number:
883-817-6918
Provider Enumeration Date:
07/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  MHC00829 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: JR68513 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".




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