Provider Demographics
NPI:1235528258
Name:RUFFIN, JOHN PAUL (LPC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PAUL
Last Name:RUFFIN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3776 SULLIVAN ST STE E
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-2344
Mailing Address - Country:US
Mailing Address - Phone:256-468-4385
Mailing Address - Fax:256-434-5165
Practice Address - Street 1:3776 SULLIVAN ST STE E
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-2344
Practice Address - Country:US
Practice Address - Phone:256-468-4385
Practice Address - Fax:256-434-5165
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-14
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3353101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional