Provider Demographics
NPI:1083823017
Name:RUBY, JANET M (LPC)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:M
Last Name:RUBY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 SUZANNE LN
Mailing Address - Street 2:
Mailing Address - City:RIDGWAY
Mailing Address - State:CO
Mailing Address - Zip Code:81432-9555
Mailing Address - Country:US
Mailing Address - Phone:970-325-7214
Mailing Address - Fax:970-325-7215
Practice Address - Street 1:559 SUZANNE LN
Practice Address - Street 2:
Practice Address - City:RIDGWAY
Practice Address - State:CO
Practice Address - Zip Code:81432-9555
Practice Address - Country:US
Practice Address - Phone:970-318-6811
Practice Address - Fax:970-325-7215
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO926101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO926OtherLICSENSED PROFESSIONAL CO