Healthcare Provider Details

I. General information

NPI: 1699966697
Provider Name (Legal Business Name): ELIZABETH RUGGIERO PHD, LPC, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELIZABETH RUGGIERO PHD, LPC, LMFT

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 395
SALIDA CO
81201-0395
US

IV. Provider business mailing address

PO BOX 395
SALIDA CO
81201-0395
US

V. Phone/Fax

Practice location:
  • Phone: 501-400-6570
  • Fax:
Mailing address:
  • Phone: 501-400-6570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP0807061
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberA04122007
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: