Provider Demographics
NPI:1740331198
Name:RUFF, MELISSA A (LCSW)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:RUFF
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 1:7220 JENNIFER WAY
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-7621
Mailing Address - Country:US
Mailing Address - Phone:410-274-3463
Mailing Address - Fax:410-795-4122
Practice Address - Street 1:10 DISTILLERY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5344
Practice Address - Country:US
Practice Address - Phone:410-871-1478
Practice Address - Fax:410-871-3219
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD098161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD438SMedicare ID - Type UnspecifiedINDIVIDUAL NUMBER