Provider Demographics
NPI:1639697238
Name:RUSCIO, LAURA BETH (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:BETH
Last Name:RUSCIO
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 DIAMOND ST
Mailing Address - Street 2:
Mailing Address - City:WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02081-3410
Mailing Address - Country:US
Mailing Address - Phone:781-726-3699
Mailing Address - Fax:
Practice Address - Street 1:190 LENOX ST
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3416
Practice Address - Country:US
Practice Address - Phone:781-769-8670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-03
Last Update Date:2017-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA218792104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker