Healthcare Provider Details

I. General information

NPI: 1023662343
Provider Name (Legal Business Name): DESTINY A RITCHIE LMSW-P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2019
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 S VIRGINIA AVE
BARTLESVILLE OK
74003-4439
US

IV. Provider business mailing address

705 S VIRGINIA AVE
BARTLESVILLE OK
74003-4439
US

V. Phone/Fax

Practice location:
  • Phone: 918-418-6164
  • Fax: 918-777-9018
Mailing address:
  • Phone: 918-418-6164
  • Fax: 918-777-9018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8772
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: