Healthcare Provider Details

I. General information

NPI: 1104576214
Provider Name (Legal Business Name): RITTER NEUROPSYCHOLOGICAL SERVICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 SALISBURY RD STE 105
JACKSONVILLE FL
32216-8035
US

IV. Provider business mailing address

4651 SALISBURY ROAD SUITE 400
JACKSONVILLE FL
32256
US

V. Phone/Fax

Practice location:
  • Phone: 864-630-1395
  • Fax: 904-337-4724
Mailing address:
  • Phone: 864-630-1395
  • Fax: 904-337-4724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. KATHRIN RITTER
Title or Position: OWNER
Credential: PHD
Phone: 864-630-1395