Provider Demographics
NPI:1275690414
Name:HOLLYWOOD, RUTH (LMHC)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:HOLLYWOOD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 NORTH MAIN STREET
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-2248
Mailing Address - Country:US
Mailing Address - Phone:508-222-0430
Mailing Address - Fax:508-222-0474
Practice Address - Street 1:120 N MAIN ST
Practice Address - Street 2:SUITE 205
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2248
Practice Address - Country:US
Practice Address - Phone:508-222-0430
Practice Address - Fax:508-222-0474
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4282101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health