Provider Demographics
NPI:1912515503
Name:RITTER, MADELINE CODY (LICSW)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:CODY
Last Name:RITTER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:MADELINE
Other - Middle Name:BLIGH
Other - Last Name:CODY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1818 E MADISON ST APT 407
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-3184
Mailing Address - Country:US
Mailing Address - Phone:603-566-0159
Mailing Address - Fax:
Practice Address - Street 1:1818 E MADISON ST APT 407
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-3184
Practice Address - Country:US
Practice Address - Phone:603-566-0159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW610120761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical