Provider Demographics
NPI:1861579005
Name:RUZANSKI, FREDERICK P (LMHC)
Entity type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:P
Last Name:RUZANSKI
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3653
Mailing Address - Country:US
Mailing Address - Phone:508-790-3375
Mailing Address - Fax:508-790-3378
Practice Address - Street 1:460 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3653
Practice Address - Country:US
Practice Address - Phone:508-790-3375
Practice Address - Fax:508-790-3378
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health