Healthcare Provider Details

I. General information

NPI: 1295068583
Provider Name (Legal Business Name): DEBBIE S RUTZ M.S.W., L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2009
Last Update Date: 09/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

671 SUNSET RD
TEANECK NJ
07666-1843
US

IV. Provider business mailing address

671 SUNSET RD
TEANECK NJ
07666-1843
US

V. Phone/Fax

Practice location:
  • Phone: 201-692-8329
  • Fax: 201-692-3222
Mailing address:
  • Phone: 201-692-8329
  • Fax: 201-692-3222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC00291000
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number44SC00291000
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: