Provider Demographics
NPI:1538346473
Name:RUSKIN, BARBARA (LPC)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:RUSKIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:
Other - Last Name:KOPPELMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:122 BARDEN CT
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-2704
Mailing Address - Country:US
Mailing Address - Phone:248-318-8165
Mailing Address - Fax:
Practice Address - Street 1:74 W LONG LAKE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-2769
Practice Address - Country:US
Practice Address - Phone:248-642-6066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009718101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor