Provider Demographics
NPI:1831884733
Name:RUFFIN, TAMKEA R (LCSW-A)
Entity type:Individual
Prefix:
First Name:TAMKEA
Middle Name:R
Last Name:RUFFIN
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 SUTHERLAND DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:27525-6614
Mailing Address - Country:US
Mailing Address - Phone:919-438-2167
Mailing Address - Fax:
Practice Address - Street 1:1765 HERITAGE CENTER DRIVE
Practice Address - Street 2:102
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587
Practice Address - Country:US
Practice Address - Phone:919-438-2167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0186821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical