Provider Demographics
NPI:1891976080
Name:RUISARD, DEBRA (LCSW, LCADC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:RUISARD
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 NELSON ST
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE STATION
Mailing Address - State:NJ
Mailing Address - Zip Code:08889-3278
Mailing Address - Country:US
Mailing Address - Phone:908-295-8597
Mailing Address - Fax:
Practice Address - Street 1:182 TAMARACK CIR
Practice Address - Street 2:
Practice Address - City:SKILLMAN
Practice Address - State:NJ
Practice Address - Zip Code:08558-2021
Practice Address - Country:US
Practice Address - Phone:609-688-8300
Practice Address - Fax:609-688-8333
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053731001041C0700X
NJ37LC00161800101YA0400X
NJ44SL05395200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker