Provider Demographics
NPI:1558708065
Name:PIKE CREEK COUNSELING
Entity Type:Organization
Organization Name:PIKE CREEK COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:K
Authorized Official - Last Name:RUOFF
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:302-898-9229
Mailing Address - Street 1:5618 KIRKWOOD HWY STE 2
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-5004
Mailing Address - Country:US
Mailing Address - Phone:302-898-9229
Mailing Address - Fax:636-944-0212
Practice Address - Street 1:5618 KIRKWOOD HWY STE 2
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5004
Practice Address - Country:US
Practice Address - Phone:302-898-9229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-24
Last Update Date:2024-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0000496103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty