Provider Demographics
NPI:1619906997
Name:HELPERT-NUNEZ, RUTH (LCSW, LMFT)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:
Last Name:HELPERT-NUNEZ
Suffix:
Gender:F
Credentials:LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1713 BROADMOOR DR
Mailing Address - Street 2:STE 100
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-5220
Mailing Address - Country:US
Mailing Address - Phone:979-255-7004
Mailing Address - Fax:979-431-4963
Practice Address - Street 1:1713 BROADMOOR DR
Practice Address - Street 2:STE 100
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-5220
Practice Address - Country:US
Practice Address - Phone:979-255-7004
Practice Address - Fax:979-431-4963
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX079951041C0700X
TX003447-042004106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX124074902Medicaid
TX124074902Medicaid