Provider Demographics
NPI:1982677704
Name:RUGGIERI, JOSEPH A (LMHC, LADC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:RUGGIERI
Suffix:
Gender:M
Credentials:LMHC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:565 TURNPIKE ST
Mailing Address - Street 2:SUITE #84
Mailing Address - City:NO ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845
Mailing Address - Country:US
Mailing Address - Phone:978-686-5013
Mailing Address - Fax:978-685-6556
Practice Address - Street 1:565 TURNPIKE ST
Practice Address - Street 2:SUITE #84
Practice Address - City:NO ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845
Practice Address - Country:US
Practice Address - Phone:978-686-5013
Practice Address - Fax:978-685-6556
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA135101Y00000X
MA199101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1890255Medicaid