Provider Demographics
NPI:1477951283
Name:RUIZ, KATHLEEN MEGAN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:MEGAN
Last Name:RUIZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 WOODBINE CT
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-1940
Mailing Address - Country:US
Mailing Address - Phone:207-475-6941
Mailing Address - Fax:
Practice Address - Street 1:550 PINETOWN RD STE 430
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-2609
Practice Address - Country:US
Practice Address - Phone:267-460-1420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-10
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
PAPC009859101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)