Provider Demographics
NPI:1629272430
Name:KIMBALL-RITTER, DEBRA (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:KIMBALL-RITTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1916 COTTAGE PL
Mailing Address - Street 2:
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-3332
Mailing Address - Country:US
Mailing Address - Phone:732-598-4344
Mailing Address - Fax:732-774-0675
Practice Address - Street 1:2002 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-4674
Practice Address - Country:US
Practice Address - Phone:732-598-4344
Practice Address - Fax:732-774-0675
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC052340001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical