Edward Mitchell Rudder, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

002712 Issued in NY

Practice address

11 Tina Dr
Gardiner, NY 12525-5412

Phone

(845) 255-0436

NPI assigned

Jan 8, 2007

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225186331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 TINA DR",
            "city": "GARDINER",
            "state": "NY",
            "postal_code": "125255412",
            "telephone_number": "845-255-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 TINA DR",
            "city": "GARDINER",
            "state": "NY",
            "postal_code": "125255412",
            "telephone_number": "845-255-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDDER",
        "first_name": "EDWARD",
        "middle_name": "MITCHELL",
        "name_prefix": "Mr.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "002712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Molinary, LPN
• Sandra Ann O'Connor, L.AC.
• Heather Lesley O'Donnell
• Sarah Jean Petroccitto, LCSW
• Seth Peyser, CH
• Patricia Helen Scognamiglio, OTR/L
• Nichole Ann Smith, D.C.
• Richard J Smith, LCSW
• Laura Elizabeth Teetz, MS
• Jessica Temple

• All providers in Gardiner, NY
• Mental Health Counselor in New York

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.