Provider Demographics
NPI:1841946548
Name:RUTH'S PLACE COUNSELING SERVICES
Entity type:Organization
Organization Name:RUTH'S PLACE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LA SHAUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-931-6732
Mailing Address - Street 1:82 CLIFFWOOD AVE UNIT 29
Mailing Address - Street 2:
Mailing Address - City:CLIFFWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07721-1082
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:82 CLIFFWOOD AVENUE
Practice Address - Street 2:UNIT 29
Practice Address - City:CLIFWOOD NJ
Practice Address - State:NJ
Practice Address - Zip Code:07721
Practice Address - Country:US
Practice Address - Phone:732-290-5781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1497287403Medicaid