Provider Demographics
NPI:1194096412
Name:RUIZ, JULIET (LCSW, CT, MA)
Entity type:Individual
Prefix:
First Name:JULIET
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:LCSW, CT, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11141 SCOTSCRAIG CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-4333
Mailing Address - Country:US
Mailing Address - Phone:702-266-6150
Mailing Address - Fax:702-233-8472
Practice Address - Street 1:6867 W CHARLESTON BLVD STE B
Practice Address - Street 2:SUITE B
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1669
Practice Address - Country:US
Practice Address - Phone:702-266-6150
Practice Address - Fax:702-233-8472
Is Sole Proprietor?:No
Enumeration Date:2012-01-18
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6770-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical