Provider Demographics
NPI:1659788677
Name:HENLEY, RUTH HELEN (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:HELEN
Last Name:HENLEY
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 EL PUEBLO RANCH WAY
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81006-2103
Mailing Address - Country:US
Mailing Address - Phone:719-404-1384
Mailing Address - Fax:719-404-1321
Practice Address - Street 1:1 EL PUEBLO RANCH WAY
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81006-2103
Practice Address - Country:US
Practice Address - Phone:719-404-1384
Practice Address - Fax:719-404-1321
Is Sole Proprietor?:No
Enumeration Date:2014-07-22
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0011909101YM0800X
COLPC.0011909101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health