Provider Demographics
NPI:1932656667
Name:RITTER, THOMAS WILLIAM (PHD LPC, CAADC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:WILLIAM
Last Name:RITTER
Suffix:
Gender:M
Credentials:PHD LPC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3005 BRODHEAD RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-9201
Mailing Address - Country:US
Mailing Address - Phone:812-701-2101
Mailing Address - Fax:
Practice Address - Street 1:3005 BRODHEAD RD
Practice Address - Street 2:SUITE 101
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-9201
Practice Address - Country:US
Practice Address - Phone:812-701-2101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-11
Last Update Date:2016-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009094101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional