Provider Demographics
NPI:1922060136
Name:RUIZ, ANABELLA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANABELLA
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14752 CHARTER RD
Mailing Address - Street 2:APT# 37 B
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-6358
Mailing Address - Country:US
Mailing Address - Phone:718-969-0717
Mailing Address - Fax:212-828-8453
Practice Address - Street 1:340 E 24TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4019
Practice Address - Country:US
Practice Address - Phone:212-996-6127
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR052587-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health