Lynnette G Ruch, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS 006874 L Issued in PA

Practice address

2819O Willow Street Pike N
Willow Street, PA 17584-9496

Phone

(717) 464-1464

Fax

(717) 464-4348

NPI assigned

Jun 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Clinical Psychologist

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Life Span Psychological Services PC

  • Clinical Psychologist
  • Willow Street, PA
  • NPI 1912958356
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280448000000",
    "number": "1629014741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 GABLE PARK RD",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "17603",
            "telephone_number": "717-872-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2819O WILLOW STREET PIKE N",
            "city": "WILLOW STREET",
            "state": "PA",
            "postal_code": "175849496",
            "telephone_number": "717-464-1464",
            "fax_number": "717-464-4348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCH",
        "first_name": "LYNNETTE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2010-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS 006874 L",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS006874L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01442642",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reppert Eye Care PLLC
• Tyler Reppert, O.D.
• Meek Rineer, BS, CFRS, AAC, CTP
• Ivelisse Rodriguez
• Dena Rene Roye
• Sarah Rush
• Susan Salisbury, MPT
• Norby N/a Santiago
• Stefanie Nicole Scarborough, LPC
• Daniel Adam Schmitt, PA-C

• Clinical Psychologist in Willow Street, PA
• Providers in Willow Street, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.