Individual provider Active NPI

Latacia Nicole Ruff, LCMHC

  • Counselor
  • Charlotte, NC
National Provider Identifier
1336580315
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
1336580315 Issued in NC
Practice address
2225 Freedom Dr
Charlotte, NC 28208-1000
Phone
(980) 302-9000
Fax
(980) 302-9025
NPI assigned
Jul 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10216 NC
Counselor 101Y00000X 1336580315 NC Primary

Addresses

Primary practice location

2225 Freedom Dr
Charlotte, NC 28208-1000

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

9716 Rea Rd
Ste B #1167
Charlotte, NC 28277-3103
Phone (704) 312-0356

Other practice location 2

5108 Reagan Dr
Ste 14
Charlotte, NC 28206-3103
Phone (704) 596-0505

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@choice-ccc.com Direct

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
1336580315NCMDCounselor
10216NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Choice Counseling & Consulting, PLLC Mental Health Current 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": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1336580315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 FREEDOM DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282081000",
            "telephone_number": "980-302-9000",
            "fax_number": "980-302-9025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9716 Rea Rd",
            "address_2": "Ste B #1167",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282773103",
            "country_code": "US",
            "telephone_number": "704-312-0356",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5108 Reagan Dr",
            "address_2": "Ste 14",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282063103",
            "country_code": "US",
            "telephone_number": "704-596-0505",
            "fax_number": "704-596-0507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUFF",
        "first_name": "LATACIA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-08",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "10216",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "1336580315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@choice-ccc.com",
            "affiliation": "N",
            "endpointDescription": "Main Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9716 Rea Rd",
            "address_2": "Ste B #1167",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282773103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.