Provider Demographics
NPI:1821524604
Name:ANDERSON-COLE, RUTH
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:ANDERSON-COLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 411
Mailing Address - Street 2:
Mailing Address - City:BRYANS ROAD
Mailing Address - State:MD
Mailing Address - Zip Code:20616-0411
Mailing Address - Country:US
Mailing Address - Phone:301-246-0084
Mailing Address - Fax:
Practice Address - Street 1:10665 STANHAVEN PL STE 300A
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-3069
Practice Address - Country:US
Practice Address - Phone:301-246-0084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP6909101Y00000X, 101YP2500X
MDLC13174101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional