Ellen Ruth Kruger, L.I.C.S.W.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

105528 Issued in MA

Practice address

84 High St
Medford, MA 02155-3844

Phone

(781) 393-0009

Fax

(781) 395-2909

NPI assigned

Jan 26, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Thrive Psychiatric Care LLC

  • Adult Mental Health Clinic/Center
  • Peabody, MA
  • NPI 1740080100
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053467563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 HAMMOND PL",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018013415",
            "telephone_number": "781-932-0559",
            "fax_number": "781-395-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 HIGH ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021553844",
            "telephone_number": "781-393-0009",
            "fax_number": "781-395-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUGER",
        "first_name": "ELLEN",
        "middle_name": "RUTH",
        "name_prefix": "Ms.",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "105528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jillian Lee Korb, CCC-SLP
• Abigail Kowalski
• Steffanie Kraucunas, RN
• Krishma Medical Associates 2 PC
• Janie L Kritzman, PHD
• Krystyna Ksiazek, L.M.H.C
• Duncan McNicol Kuhn, MD
• Samyuktha Kumar
• Alissa Susan Kuznick, LICSW
• Lorraine Lafata, LICSW

• Mental Health Counselor in Medford, MA
• Providers in Medford, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.