Provider Demographics
NPI:1619056579
Name:RUFENACHT, BARRY BRUCE (LCSW, LADC)
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:BRUCE
Last Name:RUFENACHT
Suffix:
Gender:M
Credentials:LCSW, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 COMSTOCK RD
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:VT
Mailing Address - Zip Code:05602-9610
Mailing Address - Country:US
Mailing Address - Phone:802-223-8952
Mailing Address - Fax:802-223-2665
Practice Address - Street 1:641 COMSTOCK RD
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:VT
Practice Address - Zip Code:05602-9610
Practice Address - Country:US
Practice Address - Phone:802-223-8952
Practice Address - Fax:802-223-2665
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT000218101YA0400X
VT0003911041C0700X
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
VT00028150OtherBCBS
VT1055408OtherCIGNA
VT1006712Medicaid