Justin Ruiz, LPC
Individual provider Active NPI Counselor · Marion, TX
NPI 1992379184 · NPPES record last updated May 13, 2021
Key facts
- NPI
- 1992379184
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 82931 (TX)
- Practice address
- 3201 Harvest Hill Blvd
Marion, TX 78124-1360 - Phone
- (210) 326-4072
- NPI assigned
- May 13, 2021
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 82931 | TX | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 82931 | TX | Yes |
Addresses
Primary practice location
3201 Harvest Hill Blvd
Marion, TX 78124-1360
Mailing address
3201 Harvest Hill Blvd
Marion, TX 78124-1360
Phone (210) 326-4072
Other providers in Marion, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.