Provider Demographics
NPI:1568551224
Name:RUH, DORINNA S (LCSW, CACIII)
Entity Type:Individual
Prefix:MRS
First Name:DORINNA
Middle Name:S
Last Name:RUH
Suffix:
Gender:F
Credentials:LCSW, CACIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 REMINGTON ST STE 205
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3089
Mailing Address - Country:US
Mailing Address - Phone:970-494-0631
Mailing Address - Fax:970-493-5131
Practice Address - Street 1:503 REMINGTON ST STE 205
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3089
Practice Address - Country:US
Practice Address - Phone:970-494-0631
Practice Address - Fax:970-493-5131
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5479101YA0400X
CO9925231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO486868Medicare ID - Type Unspecified