Healthcare Provider Details

I. General information

NPI: 1861541625
Provider Name (Legal Business Name): MICHAEL T. RITCHIE M.H.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BOOTH ST.
ELKTON MD
21921
US

IV. Provider business mailing address

801 LORE AVE
WILMINGTON DE
19809
US

V. Phone/Fax

Practice location:
  • Phone: 410-996-5104
  • Fax: 410-996-5197
Mailing address:
  • Phone: 302-762-3797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC2194
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: