Paviella K Ruether, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW20019 Issued in FL

Practice address

5082 NW 51St Ave
Coconut Creek, FL 33073-4925

Phone

(719) 332-3685

NPI assigned

Oct 23, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1356530695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5082 NW 51ST AVE",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734925",
            "telephone_number": "719-332-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5082 NW 51ST AVE",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734925",
            "telephone_number": "719-332-3685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1422 San Marco Blvd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078536",
            "country_code": "US",
            "telephone_number": "904-398-4133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUETHER",
        "first_name": "PAVIELLA",
        "middle_name": "K",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-23",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "20852",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW20019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter A. Rossen, DDS
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• Jena Leigh Rubenfeld
• Steve Rubin, LCSW
• Natalie Elaine Russo
• Ruthpro Incorporated
• Sagamore School, LLC
• Sage Dental of Coconut Creek , PLLC
• Sage Womens Health, LLC

• Clinical Social Worker in Coconut Creek, FL
• Providers in Coconut Creek, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.