Provider Demographics
NPI:1104576214
Name:RITTER NEUROPSYCHOLOGICAL SERVICE, LLC
Entity type:Organization
Organization Name:RITTER NEUROPSYCHOLOGICAL SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RITTER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:864-630-1395
Mailing Address - Street 1:4651 SALISBURY ROAD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256
Mailing Address - Country:US
Mailing Address - Phone:864-630-1395
Mailing Address - Fax:904-337-4724
Practice Address - Street 1:4651 SALISBURY RD STE 400
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-6187
Practice Address - Country:US
Practice Address - Phone:864-630-1395
Practice Address - Fax:904-337-4724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty