Individual provider Active NPI

Courtney L Ruetz, LMFT

  • Marriage & Family Therapist
  • Wylie, TX
National Provider Identifier
1275271009
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
204582 Issued in TX
Practice address
303 S Highway 78 Ste 100
Wylie, TX 75098-3957
Phone
(469) 342-3468
NPI assigned
May 23, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 204582 TX Primary

Addresses

Primary practice location

303 S Highway 78 Ste 100
Wylie, TX 75098-3957

Mailing address

2316 Malone Dr
McKinney, TX 75072-2964
Phone (214) 878-3546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20240614000764 TX Practitioner - Marriage and Family Therapist 2264975549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CCNT IncGroup PAC ID 3173809621, 16 clinicians

Practice addresses (Care Compare)

303 S Hwy 78
Suite 100
Wylie, TX 75098-3957
Phone (469) 342-3468

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
204582TXMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
CCNT Inc. Multi-Specialty CurrentSince May 28, 2024 Accepting new patients

Locations

720 E Park Blvd
Ste 204
Plano, TX 75074
Phone (469) 342-3468

303 S Highway 78
Ste 100
Wylie, TX 75098
Phone (469) 342-3468

303 S Highway 78
Ste 103
Wylie, TX 75098
Phone (469) 342-3468

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": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1275271009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2316 MALONE DR",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750722964",
            "telephone_number": "214-878-3546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S HIGHWAY 78 STE 100",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750983957",
            "telephone_number": "469-342-3468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUETZ",
        "first_name": "COURTNEY",
        "middle_name": "L",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-23",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "204582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wylie, TX

Sources for this page

Verify at the official NPI Registry.