Provider Demographics
NPI:1790871366
Name:PARITZKY, RICHARD S (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:S
Last Name:PARITZKY
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 1:1342 COLONIAL BLVD
Mailing Address - Street 2:BUILDING B - SUITE 13
Mailing Address - City:FT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907
Mailing Address - Country:US
Mailing Address - Phone:239-931-4444
Mailing Address - Fax:239-931-4440
Practice Address - Street 1:1342 COLONIAL BLVD
Practice Address - Street 2:BUILDING B - SUITE 13
Practice Address - City:FT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907
Practice Address - Country:US
Practice Address - Phone:239-931-4444
Practice Address - Fax:239-931-4440
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7594101YM0800X
VA0701000125101YP2500X
VA0810001832103TC0700X
VA0717000256106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ041SOtherBC/BS
FLMH7564OtherLICENSE NUMBER