Provider Demographics
NPI:1407372790
Name:RUGER, MATTHEW L (MA, LPC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:L
Last Name:RUGER
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 S SANTA CLAUS LN
Mailing Address - Street 2:
Mailing Address - City:NORTH POLE
Mailing Address - State:AK
Mailing Address - Zip Code:99705-7754
Mailing Address - Country:US
Mailing Address - Phone:907-490-7233
Mailing Address - Fax:907-490-7234
Practice Address - Street 1:145 S SANTA CLAUS LN
Practice Address - Street 2:
Practice Address - City:NORTH POLE
Practice Address - State:AK
Practice Address - Zip Code:99705-7754
Practice Address - Country:US
Practice Address - Phone:907-490-7233
Practice Address - Fax:907-490-7234
Is Sole Proprietor?:No
Enumeration Date:2017-08-17
Last Update Date:2023-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK122317101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional