Provider Demographics
NPI:1467297051
Name:RITCHIE, ZIVA (ADT)
Entity type:Individual
Prefix:
First Name:ZIVA
Middle Name:
Last Name:RITCHIE
Suffix:
Gender:F
Credentials:ADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4805 GARRISON BLVD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5695
Mailing Address - Country:US
Mailing Address - Phone:443-869-2600
Mailing Address - Fax:
Practice Address - Street 1:7705 HILLENDALE RD APT B
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-6048
Practice Address - Country:US
Practice Address - Phone:443-540-7272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDADT3492101YA0400X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)