Provider Demographics
NPI:1407005416
Name:RUFFER, PAUL E (MSW (LICSW & LCSW-C))
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:E
Last Name:RUFFER
Suffix:
Gender:M
Credentials:MSW (LICSW & LCSW-C)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11809 STONINGTON PL
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-1616
Mailing Address - Country:US
Mailing Address - Phone:301-754-3838
Mailing Address - Fax:
Practice Address - Street 1:1050 17TH ST NW
Practice Address - Street 2:SUITE 1000
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5503
Practice Address - Country:US
Practice Address - Phone:202-641-3981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13575101YM0800X
DCLC300557101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC11233018OtherCAQH
DC64239503OtherCAREFIRST OF MARYLAND (NON-PAR PROVIDER)
DC1698133 & PIN # 7248OtherAETNA
DC492099Medicare PIN