Healthcare Provider Details

I. General information

NPI: 1730419649
Provider Name (Legal Business Name): STEPHANIE HALL RUTLEDGE PH.D. , LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2009
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 COLLEGE HL
WESTMINSTER MD
21157-4390
US

IV. Provider business mailing address

2 COLLEGE HL
WESTMINSTER MD
21157-4390
US

V. Phone/Fax

Practice location:
  • Phone: 410-368-4668
  • Fax:
Mailing address:
  • Phone: 410-368-4668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC16492
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00399900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: