Provider Demographics
NPI:1922278779
Name:RUCH, MARK E (LPC)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:E
Last Name:RUCH
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SIL - P.O. BOX 2270
Mailing Address - Street 2:
Mailing Address - City:MANILA
Mailing Address - State:PHILIPPINES
Mailing Address - Zip Code:1099
Mailing Address - Country:PH
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:FAITH ACADEMY, PENNY LANE, VALLEY GOLF SUBD.
Practice Address - Street 2:DON CELSO TUAZON AVENUE
Practice Address - City:CAINTA
Practice Address - State:RIZAL
Practice Address - Zip Code:1900
Practice Address - Country:PH
Practice Address - Phone:658-0048
Practice Address - Fax:658-0026
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4948101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional