Provider Demographics
NPI:1114228004
Name:RUPERT, J F (DSC, PHD, DD)
Entity Type:Individual
Prefix:DR
First Name:J
Middle Name:F
Last Name:RUPERT
Suffix:
Gender:M
Credentials:DSC, PHD, DD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 28
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:OH
Mailing Address - Zip Code:45640-0028
Mailing Address - Country:US
Mailing Address - Phone:740-978-0676
Mailing Address - Fax:
Practice Address - Street 1:404 STATE ROUTE 327
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:OH
Practice Address - Zip Code:45640-9282
Practice Address - Country:US
Practice Address - Phone:740-978-0676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-08
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist