Healthcare Provider Details

I. General information

NPI: 1740331198
Provider Name (Legal Business Name): MELISSA A RUFF LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2007
Last Update Date: 02/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 DISTILLERY RD SUITE 200
WESTMINSTER MD
21157-5344
US

IV. Provider business mailing address

7220 JENNIFER WAY
SYKESVILLE MD
21784-7621
US

V. Phone/Fax

Practice location:
  • Phone: 410-871-1478
  • Fax: 410-871-3219
Mailing address:
  • Phone: 410-274-3463
  • Fax: 410-795-4122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number09816
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: