Provider Demographics
NPI:1003981614
Name:MONIKA RUKUS, INC.
Entity Type:Organization
Organization Name:MONIKA RUKUS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONIKA
Authorized Official - Middle Name:L
Authorized Official - Last Name:RUKUS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:301-986-9999
Mailing Address - Street 1:8901 CONNECTICUT AVE
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-6734
Mailing Address - Country:US
Mailing Address - Phone:301-986-9999
Mailing Address - Fax:
Practice Address - Street 1:8901 CONNECTICUT AVE
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6734
Practice Address - Country:US
Practice Address - Phone:301-986-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08641101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD491001Medicare ID - Type Unspecified