Provider Demographics
NPI:1437920022
Name:RULAND, MARCY (LMSW)
Entity Type:Individual
Prefix:
First Name:MARCY
Middle Name:
Last Name:RULAND
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MARCY
Other - Middle Name:BREE
Other - Last Name:RULAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:568 COUNTY HIGHWAY 126
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-6274
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:568 COUNTY HIGHWAY 126
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-6274
Practice Address - Country:US
Practice Address - Phone:518-331-9325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY067075-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty