Provider Demographics
NPI:1396912259
Name:WENTZ, RUTHANNE RUSHTON (LPC)
Entity type:Individual
Prefix:MRS
First Name:RUTHANNE
Middle Name:RUSHTON
Last Name:WENTZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 FOREST CIR
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-9386
Mailing Address - Country:US
Mailing Address - Phone:717-476-9770
Mailing Address - Fax:717-637-0169
Practice Address - Street 1:6 FOREST CIR
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-9386
Practice Address - Country:US
Practice Address - Phone:717-476-9770
Practice Address - Fax:717-637-0169
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA101YM0800X, 106H00000X
PAPC004723101YP2500X
PA2599007842101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist