Individual provider Active NPI

Ruth Trudeau, L.M.F.T., L.A.D.C.

  • Marriage & Family Therapist
  • Lakeville, CT
National Provider Identifier
1194967679
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
000601 Issued in CT
Practice address
15 Porter St
Lakeville, CT 06039-1214
Phone
(860) 435-3505
Fax
(860) 435-3505
NPI assigned
Mar 31, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 000318 CT
Marriage & Family Therapist 106H00000X 000601 CT Primary

Addresses

Primary practice location

15 Porter St
Lakeville, CT 06039-1214

Mailing address

PO Box 4
Lakeville, CT 06039-0004
Phone (860) 435-3505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
000318CTMDAddiction (Substance Use Disorder) Counselor
000601CTMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ruth Trudeau, LMFT, Ladc Addiction (Substance Use Disorder) Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1238457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355788800000",
    "number": "1194967679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4",
            "city": "LAKEVILLE",
            "state": "CT",
            "postal_code": "060390004",
            "telephone_number": "860-435-3505",
            "fax_number": "860-435-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PORTER ST",
            "city": "LAKEVILLE",
            "state": "CT",
            "postal_code": "060391214",
            "telephone_number": "860-435-3505",
            "fax_number": "860-435-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUDEAU",
        "first_name": "RUTH",
        "credential": "L.M.F.T., L.A.D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-31",
        "last_updated": "2012-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "000318",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "000601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.