MEDICARE: MONTE RITCHEY

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	1041C0700X	Clinical Social Worker	34010937A	IN

General Provider Information

NPI Number	:	1588428429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONTE RITCHEY

Provider Business Mailing Address
First Line	:	4601 BAYARD PARK DR STE D
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47714-0601
Country	:	US
Telephone Number	:	812-437-1700
Fax Number	:	812-437-1702

Provider Business Practice Location Address
First Line	:	4601 BAYARD PARK DR STE D
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47714-0601
Country	:	US
Telephone Number	:	812-437-1700
Fax Number	:	812-437-1702

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

Provider Enumeration Date	:	02/12/2024
Last Update Date	:	01/20/2026

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Directions to “ MONTE RITCHEY ” Practice Location

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