Provider Demographics
NPI:1588094122
Name:DEVITO, RUTH (MA)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:DEVITO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:
Other - Last Name:CORTEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1101 EXCHANGE PL APT 537
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-1890
Mailing Address - Country:US
Mailing Address - Phone:954-643-9196
Mailing Address - Fax:
Practice Address - Street 1:943 W ANDREWS AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-2516
Practice Address - Country:US
Practice Address - Phone:252-433-0061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-18
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NCA12691101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health