Provider Demographics
NPI:1508276700
Name:RUSCITTI, VICKI (LPC, CAC II)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:
Last Name:RUSCITTI
Suffix:
Gender:F
Credentials:LPC, CAC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 H ST
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631-9115
Mailing Address - Country:US
Mailing Address - Phone:970-347-1302
Mailing Address - Fax:
Practice Address - Street 1:1260 H ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-9115
Practice Address - Country:US
Practice Address - Phone:970-347-1302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
COLPC.0014330101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst