Provider Demographics
NPI:1356012470
Name:STACY RUSE COUNSELING PLLC
Entity Type:Organization
Organization Name:STACY RUSE COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC
Authorized Official - Phone:720-526-8102
Mailing Address - Street 1:825 DELAWARE AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-6169
Mailing Address - Country:US
Mailing Address - Phone:720-526-8102
Mailing Address - Fax:817-412-7031
Practice Address - Street 1:4380 S SYRACUSE ST STE 320
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-2420
Practice Address - Country:US
Practice Address - Phone:720-526-8102
Practice Address - Fax:817-412-7031
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STACY RUSE COUNSELING PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-28
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Multi-Specialty