Individual provider Active NPI

Danielle Ruiz, LPC

  • Professional Counselor
  • Bala Cynwyd, PA
National Provider Identifier
1780224188
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC012025 Issued in PA
Practice address
600 Righters Ferry Rd PH 640
Bala Cynwyd, PA 19004-1324
Phone
(609) 980-5602
NPI assigned
Jan 14, 2020
Last updated
Aug 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC012025 PA Primary

Addresses

Primary practice location

600 Righters Ferry Rd PH 640
Bala Cynwyd, PA 19004-1324

Mailing address

109 Arlington Ave
Oaklyn, NJ 08107-1901
Phone (609) 980-5602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20241007002619 NJ Practitioner - Mental Health Counselor 5092246660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

73 N Maple Ave B
Kennedy Health Alliance
Marlton, NJ 08053-1782
Phone (844) 542-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC012025PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Medical Group Practice P.C. CurrentSince Sep 9, 2024 Accepting new patients
Kennedy Medical Group Practice, P.C. Current Accepting new patients
Kennedy Medical Group Practice PC CurrentSince Sep 9, 2024 Accepting new patients

Locations

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

73 N Maple Ave
Ste B
Marlton, NJ 08053
Phone (856) 596-0558

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1780224188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 ARLINGTON AVE",
            "city": "OAKLYN",
            "state": "NJ",
            "postal_code": "081071901",
            "telephone_number": "609-980-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 RIGHTERS FERRY RD PH 640",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041324",
            "telephone_number": "609-980-5602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "DANIELLE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-14",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC012025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bala Cynwyd, PA

Sources for this page

Verify at the official NPI Registry.