Individual provider Active NPI

Ruth Trujillo-Pertew, LCSW

  • Clinical Social Worker
  • Saint Petersburg, FL
National Provider Identifier
1245544279
Registry record updated Aug 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
20374 Issued in FL
Practice address
267 Seahorse Dr SE Apt C
Saint Petersburg, FL 33705-4098
Phone
(516) 974-8808
NPI assigned
Aug 2, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC06072600 NJ
Clinical Social Worker 1041C0700X 082658 NY
Clinical Social Worker 1041C0700X 66614 TX
Clinical Social Worker 1041C0700X 20374 FL Primary

Addresses

Primary practice location

267 Seahorse Dr SE Apt C
Saint Petersburg, FL 33705-4098

Mailing address

267 Seahorse Dr SE Apt C
Saint Petersburg, FL 33705-4098
Phone (516) 974-8808

Other practice location 1

397 Bridge St Fl 7
Brooklyn, NY 11201-5247
Phone (516) 974-8808

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://hushforms.com/thesoulfilledpath-secure-contact-form Other

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
20374FLMDClinical Social Worker
44SC06072600NJMDClinical Social Worker
082658NYMDClinical Social Worker
66614TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Copay, Inc. 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": "1280707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723939200000",
    "number": "1245544279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 SEAHORSE DR SE APT C",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337054098",
            "telephone_number": "516-974-8808",
            "fax_number": "516-482-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 SEAHORSE DR SE APT C",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337054098",
            "telephone_number": "516-974-8808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "397 Bridge St Fl 7",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112015247",
            "country_code": "US",
            "telephone_number": "516-974-8808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRUJILLO-PERTEW",
        "first_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-02",
        "last_updated": "2024-08-18",
        "certification_date": "2024-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06072600",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "082658",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "66614",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "20374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://hushforms.com/thesoulfilledpath-secure-contact-form",
            "affiliation": "N",
            "endpointDescription": "Contact form",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Secure webform for receiving client information",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "protected health information",
            "address_1": "267 Seahorse Dr SE Apt C",
            "city": "Saint Petersburg",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337054098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2024; 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.