Provider Demographics
NPI:1982255337
Name:RUIZ, VINCENT JR (LPC)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
Last Name:RUIZ
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 E BAY AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-3104
Mailing Address - Country:US
Mailing Address - Phone:609-389-1768
Mailing Address - Fax:
Practice Address - Street 1:142 E BAY AVE STE B
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-3104
Practice Address - Country:US
Practice Address - Phone:609-389-1768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-26
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00837000101YP2500X
NJ37AC00449700101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional