Provider Demographics
NPI:1396707881
Name:RUZANIC, JOYCE GRIMES (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:GRIMES
Last Name:RUZANIC
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 DUBONNET CT
Mailing Address - Street 2:
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-3246
Mailing Address - Country:US
Mailing Address - Phone:412-364-7962
Mailing Address - Fax:
Practice Address - Street 1:6324 MARCHAND ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-4312
Practice Address - Country:US
Practice Address - Phone:412-661-1239
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACWO13167101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA092683Medicare ID - Type Unspecified