Provider Demographics
NPI:1750406799
Name:RITCHIE, MINDI L (LPC)
Entity type:Individual
Prefix:
First Name:MINDI
Middle Name:L
Last Name:RITCHIE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MINDI
Other - Middle Name:L
Other - Last Name:PAMPEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:712 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:GALESBURG
Mailing Address - State:IL
Mailing Address - Zip Code:61401-2721
Mailing Address - Country:US
Mailing Address - Phone:309-221-6674
Mailing Address - Fax:
Practice Address - Street 1:2323 WINDISH DR
Practice Address - Street 2:
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-9780
Practice Address - Country:US
Practice Address - Phone:309-344-4200
Practice Address - Fax:309-344-4281
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178-004108101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL178-004108OtherSTATE LICENSE
IL370984175OtherFEIN CORPORATION