MEDICARE: DR. SANDRA H RITTER PH.D., LPC, LCMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	AZ-LPC17442	AZ

General Provider Information

NPI Number	:	1447249685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANDRA H RITTER PH.D., LPC, LCMHC

Provider Business Mailing Address
First Line	:	4411 E CHANDLER BLVD APT 1128
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85048-7667
Country	:	US
Telephone Number	:	704-496-3651
Fax Number	:	704-793-1098

Provider Business Practice Location Address
First Line	:	4411 E CHANDLER BLVD APT 1128
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85048-7667
Country	:	US
Telephone Number	:	704-496-3651
Fax Number	:	928-438-0107

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	07/05/2023

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