Provider Demographics
NPI:1114154523
Name:JONES-RUFFIN, NADINE M (LSWA)
Entity Type:Individual
Prefix:
First Name:NADINE
Middle Name:M
Last Name:JONES-RUFFIN
Suffix:
Gender:F
Credentials:LSWA
Other - Prefix:
Other - First Name:NADINE
Other - Middle Name:M
Other - Last Name:JONES-RUFFIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LSWA
Mailing Address - Street 1:2 LEXINGTON ST
Mailing Address - Street 2:
Mailing Address - City:EAST BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02128-1666
Mailing Address - Country:US
Mailing Address - Phone:617-569-4561
Mailing Address - Fax:617-418-8133
Practice Address - Street 1:2 LEXINGTON ST
Practice Address - Street 2:
Practice Address - City:EAST BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02128-1666
Practice Address - Country:US
Practice Address - Phone:617-569-4561
Practice Address - Fax:617-418-8133
Is Sole Proprietor?:No
Enumeration Date:2009-06-12
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA413078101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor