Provider Demographics
NPI:1275968943
Name:RITHOLZ, SUSAN (PHD, LCSW-R)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:RITHOLZ
Suffix:
Gender:F
Credentials:PHD, LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 MACDONOUGH ST
Mailing Address - Street 2:1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-1012
Mailing Address - Country:US
Mailing Address - Phone:718-398-1130
Mailing Address - Fax:
Practice Address - Street 1:319 MACDONOUGH ST
Practice Address - Street 2:1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-1012
Practice Address - Country:US
Practice Address - Phone:718-398-1130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0587341101YM0800X, 283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No283Q00000XHospitalsPsychiatric Hospital