Provider Demographics
NPI:1952879256
Name:RUANE, LISA C (LCSW, CHT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:C
Last Name:RUANE
Suffix:
Gender:F
Credentials:LCSW, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 KINDERKAMACK RD FL 2
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-2102
Mailing Address - Country:US
Mailing Address - Phone:201-416-9043
Mailing Address - Fax:
Practice Address - Street 1:334 KINDERKAMACK RD FL 2
Practice Address - Street 2:
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-2102
Practice Address - Country:US
Practice Address - Phone:201-416-9043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-05
Last Update Date:2025-02-04
Deactivation Date:2018-11-06
Deactivation Code:
Reactivation Date:2025-02-04
Provider Licenses
StateLicense IDTaxonomies
NJ44SC056231001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical