Provider Demographics
NPI:1679635379
Name:RUFF, RICHARD IRVING (LPC 14434)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:IRVING
Last Name:RUFF
Suffix:
Gender:M
Credentials:LPC 14434
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14769 W COLUMBINE DR
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-5940
Mailing Address - Country:US
Mailing Address - Phone:602-618-5222
Mailing Address - Fax:
Practice Address - Street 1:17505 N 79TH AVE STE 213
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8728
Practice Address - Country:US
Practice Address - Phone:602-618-5222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-16
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor