Provider Demographics
NPI:1386061109
Name:RUIZ, NANETH (LPC)
Entity type:Individual
Prefix:
First Name:NANETH
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 W MEADOWVIEW RD STE 112
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-3408
Mailing Address - Country:US
Mailing Address - Phone:336-252-3932
Mailing Address - Fax:336-218-6808
Practice Address - Street 1:2211 W MEADOWVIEW RD STE 112
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-3408
Practice Address - Country:US
Practice Address - Phone:336-252-3932
Practice Address - Fax:336-218-6808
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-19
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10744101YP2500X
NCPC11066251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional