Provider Demographics
NPI:1760588156
Name:RITCHIE, SCOTT ANDERSON (PHD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:ANDERSON
Last Name:RITCHIE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 STONEY CLIFF RD
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02632-2837
Mailing Address - Country:US
Mailing Address - Phone:508-221-8383
Mailing Address - Fax:833-525-1928
Practice Address - Street 1:1025 MAIN ST
Practice Address - Street 2:
Practice Address - City:W BARNSTABLE
Practice Address - State:MA
Practice Address - Zip Code:02668-1163
Practice Address - Country:US
Practice Address - Phone:508-221-8383
Practice Address - Fax:833-525-1928
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1056103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39040000Medicaid
WI39040000Medicaid