Provider Demographics
NPI:1386785442
Name:RICHTER, ELLEN MARIE (PHD PSYCHOLOGY)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:MARIE
Last Name:RICHTER
Suffix:
Gender:F
Credentials:PHD PSYCHOLOGY
Other - Prefix:
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Mailing Address - Street 1:10705 70TH AVE
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4300
Mailing Address - Country:US
Mailing Address - Phone:212-838-3420
Mailing Address - Fax:212-208-2474
Practice Address - Street 1:13719 14TH AVE
Practice Address - Street 2:
Practice Address - City:COLLEGE POINT
Practice Address - State:NY
Practice Address - Zip Code:11356-2011
Practice Address - Country:US
Practice Address - Phone:212-838-3420
Practice Address - Fax:212-208-2474
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2014-01-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY006082103TB0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral