Individual provider Active NPI

Stephen John Ritz, PH.D.

  • Clinical Psychologist
  • Decatur, GA
National Provider Identifier
1194803536
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1515 Issued in GA
Practice address
2785 Lawrenceville Hwy
Suite 108
Decatur, GA 30033-2515
Phone
(770) 270-5488
Fax
(770) 270-8876
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1515 GA Primary

Addresses

Primary practice location

2785 Lawrenceville Hwy
Suite 108
Decatur, GA 30033-2515

Mailing address

2785 Lawrenceville Hwy
Suite 108
Decatur, GA 30033-2515
Phone (770) 270-5488

Other identifiers 1

IdentifierTypeStateIssuer
00455298AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120913000635 GA Practitioner - Clinical Psychologist 8426206574 Practice locations: Decatur, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2785 Lawrenceville Hwy
Suite 108
Decatur, GA 30033
Phone (770) 270-5488

2785 Lawrenceville Hwy 108
Decatur, GA 30033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1515GAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rainbow Counseling & Consultation Services LLC Clinical Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1194803536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2785 LAWRENCEVILLE HWY",
            "address_2": "SUITE 108",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332515",
            "telephone_number": "770-270-5488",
            "fax_number": "770-270-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2785 LAWRENCEVILLE HWY",
            "address_2": "SUITE 108",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332515",
            "telephone_number": "770-270-5488",
            "fax_number": "770-270-8876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RITZ",
        "first_name": "STEPHEN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "1515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00455298A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.