MEDICARE: CONNECTED NEURODIVERGENT SUPPORTS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1467383539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONNECTED NEURODIVERGENT SUPPORTS, LLC

Provider Business Mailing Address
First Line	:	100 ATLANTIC AVE APT 900
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90802-5150
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9648 51ST ST NE
Second Line	:
City	:	SAINT MICHAEL
State	:	MN
Zip	:	55376-7530
Country	:	US
Telephone Number	:	310-704-1891
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	KIRSTIE RUHLAND
Credential	:	CCC-SLP, BCBA
Telephone Number	:	310-704-1891

Provider Enumeration Date	:	05/27/2026
Last Update Date	:	05/27/2026

Similar Medicare Providers

1871448308 — JANET BOSIBORI BINYANYA
Practice Location Address:

9620 51ST ST NE
SAINT MICHAEL, MN
55376-7530

Practice Phone: 612-806-6535
Practice Fax:

1073529111 — MR. PAUL DOUGLAS DRAKE JR. BA
Practice Location Address:

7530 CANTON AVE
SAINT LOUIS, MO
63130-1614

Practice Phone: 314-726-0464
Practice Fax: 314-382-0952

1124257159 — JOEL C LAU LMHP
Practice Location Address:

604 N SAINT JOSEPH AVE
HASTINGS, NE
68901-7530

Practice Phone: 402-984-9187
Practice Fax:

1376891358 — PARKER BEHAVIORAL CONSULTING, INC.
Practice Location Address:

7200 5TH AVE N
SAINT PETERSBURG, FL
33710-7530

Practice Phone: 727-418-6748
Practice Fax: 866-240-1913

1295169704 — BRIAN CROUSE LIPC
Practice Location Address:

604 N SAINT JOSEPH AVE
HASTINGS, NE
68901-7530

Practice Phone: 402-310-5607
Practice Fax: 360-363-5607

1023593928 — MISS CHLOE CIARRA SMITH-FERGUSON MSW, LCSW
Practice Location Address:

4222 SUMMIT KNOLL DR APT I
SAINT LOUIS, MO
63129-7530

Practice Phone: 618-367-6586
Practice Fax:

Directions to “CONNECTED NEURODIVERGENT SUPPORTS, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.