Provider Demographics
NPI:1477128098
Name:RUGGIERO, JULIA C (LCSW)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:C
Last Name:RUGGIERO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 BEAVERBROOK CT
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-4301
Mailing Address - Country:US
Mailing Address - Phone:203-859-1674
Mailing Address - Fax:
Practice Address - Street 1:57 BEAVERBROOK CT
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-4301
Practice Address - Country:US
Practice Address - Phone:513-760-6524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0132721041C0700X
CT5287104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical