Beth Rutkowski, L.P., C.A.A.D.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301014879 Issued in MI

Practice address

8623 N Wayne Rd
Westland, MI 48185-1137

Phone

(734) 425-0636

NPI assigned

Jan 24, 2011

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dr Beth Rutkowski, LP PLLC

  • Clinical Psychologist
  • Northville, MI
  • NPI 1578194486
  NPD (past) Authorized official
• Hegira Health, Inc.

  • Primary Care Clinic/Center
  • Westland, MI
  • NPI 1477141356
  NPD (past)

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

{
    "created_epoch": "1295827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388620800000",
    "number": "1881999829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1247 WOODWARD AVE",
            "address_2": "APT 1010",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482262025",
            "telephone_number": "734-395-5622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8623 N WAYNE RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481851137",
            "telephone_number": "734-425-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTKOWSKI",
        "first_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "L.P., C.A.A.D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-24",
        "last_updated": "2014-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014879",
            "primary": true
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "C-02694",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alissa A Ruder, OTR/L
• Tierra Rene Russaw
• Daniel Russell
• Tylermarie L Russell
• April Ruthig, LLMSW
• RX Care Solutions
• RX Care Specialty Pharmacy LLC
• RX Care Specialty Pharmacy LLC
• RX Express Pharmacy LLC
• Kristin Mary Ryeson Dzahristos, MSW LMSW

• Clinical Psychologist in Westland, MI
• Providers in Westland, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; 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.