Provider Demographics
NPI:1154136547
Name:RUBY MENTAL HEALTH PLLC
Entity type:Organization
Organization Name:RUBY MENTAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANI
Authorized Official - Middle Name:AMBER MARIE
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:MPS, LPCC
Authorized Official - Phone:651-468-5036
Mailing Address - Street 1:882 W. 7TH STREET
Mailing Address - Street 2:UNIT #1
Mailing Address - City:ST. PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102
Mailing Address - Country:US
Mailing Address - Phone:651-442-0783
Mailing Address - Fax:
Practice Address - Street 1:882 W. 7TH STREET
Practice Address - Street 2:UNIT #1
Practice Address - City:ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102
Practice Address - Country:US
Practice Address - Phone:651-442-0783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty