Provider Demographics
NPI:1790732733
Name:RITTER, HARRY AUSTIN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:HARRY
Middle Name:AUSTIN
Last Name:RITTER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MONONGAHELA
Mailing Address - State:PA
Mailing Address - Zip Code:15063-2442
Mailing Address - Country:US
Mailing Address - Phone:724-518-5103
Mailing Address - Fax:724-258-3203
Practice Address - Street 1:219 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-2442
Practice Address - Country:US
Practice Address - Phone:724-518-5103
Practice Address - Fax:724-258-3203
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW-0142421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA097562Medicare ID - Type Unspecified