Provider Demographics
NPI:1770212623
Name:RITTENHOUSE, JULIE A (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:A
Last Name:RITTENHOUSE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11900 YORKSHIRE
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49083-9618
Mailing Address - Country:US
Mailing Address - Phone:231-409-0988
Mailing Address - Fax:
Practice Address - Street 1:11900 YORKSHIRE
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:MI
Practice Address - Zip Code:49083-9618
Practice Address - Country:US
Practice Address - Phone:231-409-0988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010874351041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical