Provider Demographics
NPI:1437592193
Name:CRUMPLAR, RUTH (LPC, MAC)
Entity Type:Individual
Prefix:MISS
First Name:RUTH
Middle Name:
Last Name:CRUMPLAR
Suffix:
Gender:F
Credentials:LPC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E UNIVERSITY AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-6814
Mailing Address - Country:US
Mailing Address - Phone:877-800-5722
Mailing Address - Fax:512-257-1763
Practice Address - Street 1:7104 BERKMAN DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-3403
Practice Address - Country:US
Practice Address - Phone:877-800-5722
Practice Address - Fax:512-257-1763
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-12
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67642101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional