Provider Demographics
NPI:1760485395
Name:STRESS OPERATIONS GROUP, INC
Entity Type:Organization
Organization Name:STRESS OPERATIONS GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:RITTER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, ACSW
Authorized Official - Phone:260-744-0602
Mailing Address - Street 1:5800 FAIRFIELD AVE
Mailing Address - Street 2:STE 210
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46807-3417
Mailing Address - Country:US
Mailing Address - Phone:260-744-0602
Mailing Address - Fax:260-745-5191
Practice Address - Street 1:5800 FAIRFIELD AVE
Practice Address - Street 2:STE 210
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46807-3417
Practice Address - Country:US
Practice Address - Phone:260-744-0602
Practice Address - Fax:260-745-5191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003766101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN206850Medicare ID - Type Unspecified