Provider Demographics
NPI:1225303597
Name:RUGGLES, BECKI (LPC, M ED)
Entity Type:Individual
Prefix:
First Name:BECKI
Middle Name:
Last Name:RUGGLES
Suffix:
Gender:F
Credentials:LPC, M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27995 ROCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:MO
Mailing Address - Zip Code:65556-8216
Mailing Address - Country:US
Mailing Address - Phone:573-855-6857
Mailing Address - Fax:573-765-4350
Practice Address - Street 1:27995 ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:MO
Practice Address - Zip Code:65556-8216
Practice Address - Country:US
Practice Address - Phone:573-855-6857
Practice Address - Fax:573-765-4350
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-20
Last Update Date:2014-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011016800101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor