Provider Demographics
NPI:1487286720
Name:RITCHESON, JOHN R (LCPC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:R
Last Name:RITCHESON
Suffix:
Gender:
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 FULLERTON RD
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:IL
Mailing Address - Zip Code:62226-2901
Mailing Address - Country:US
Mailing Address - Phone:618-744-0840
Mailing Address - Fax:618-257-0641
Practice Address - Street 1:520 FULLERTON RD
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:IL
Practice Address - Zip Code:62226-2901
Practice Address - Country:US
Practice Address - Phone:618-744-0840
Practice Address - Fax:618-257-0641
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-05
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.012717101Y00000X
IL108.012717101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor