Provider Demographics
NPI:1538673843
Name:KERBELIS, RUTA (MA)
Entity Type:Individual
Prefix:
First Name:RUTA
Middle Name:
Last Name:KERBELIS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 MONTVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-1919
Mailing Address - Country:US
Mailing Address - Phone:303-884-3425
Mailing Address - Fax:
Practice Address - Street 1:2206 VICTOR ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7400
Practice Address - Country:US
Practice Address - Phone:303-884-3425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-22
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0001356101YP2500X
CONLC.0013526101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health