Healthcare Provider Details

I. General information

NPI: 1750808366
Provider Name (Legal Business Name): RITCHIE CHARLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2017
Last Update Date: 07/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2369 2ND AVE
NEW YORK NY
10035-3108
US

IV. Provider business mailing address

1265 E 93RD ST FL 2
BROOKLYN NY
11236-4322
US

V. Phone/Fax

Practice location:
  • Phone: 212-876-2300
  • Fax: 212-722-7618
Mailing address:
  • Phone: 347-864-8075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: