Provider Demographics
NPI:1639294093
Name:RITER, JANE E (MS, LMHC,LCPC)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:E
Last Name:RITER
Suffix:
Gender:F
Credentials:MS, LMHC,LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:KEOKUK
Mailing Address - State:IA
Mailing Address - Zip Code:52632-5903
Mailing Address - Country:US
Mailing Address - Phone:319-524-1971
Mailing Address - Fax:
Practice Address - Street 1:400 SOUTH BROADWAY
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-9407
Practice Address - Country:US
Practice Address - Phone:319-752-4000
Practice Address - Fax:319-752-6933
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0196154101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health