Provider Demographics
NPI:1649583741
Name:CLAUDIA RUIZ, LCPC, LLC
Entity Type:Organization
Organization Name:CLAUDIA RUIZ, LCPC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:312-217-7544
Mailing Address - Street 1:111 N WABASH AVE
Mailing Address - Street 2:SUITE 1319
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-1903
Mailing Address - Country:US
Mailing Address - Phone:312-217-7544
Mailing Address - Fax:312-268-6562
Practice Address - Street 1:1300 W BELMONT AVE
Practice Address - Street 2:SUITE 316
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3200
Practice Address - Country:US
Practice Address - Phone:312-217-7544
Practice Address - Fax:312-268-6562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180006563101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL180006563OtherLCPC LICENSE