Provider Demographics
NPI:1245544279
Name:TRUJILLO-PERTEW, RUTH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:
Last Name:TRUJILLO-PERTEW
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 1:267 SEAHORSE DR SE APT C
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-4098
Mailing Address - Country:US
Mailing Address - Phone:516-974-8808
Mailing Address - Fax:516-482-3146
Practice Address - Street 1:267 SEAHORSE DR SE APT C
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-4098
Practice Address - Country:US
Practice Address - Phone:516-974-8808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2024-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC060726001041C0700X
NY0826581041C0700X
TX666141041C0700X
FL203741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical