Healthcare Provider Details

I. General information

NPI: 1881490613
Provider Name (Legal Business Name): RUTH A DENNIS LPCC, ATR-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2025
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2019 GALISTEO ST STE A
SANTA FE NM
87505-2143
US

IV. Provider business mailing address

2019 GALISTEO ST STE A
SANTA FE NM
87505-2143
US

V. Phone/Fax

Practice location:
  • Phone: 505-477-1138
  • Fax:
Mailing address:
  • Phone: 505-477-1138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number24-720
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCTB-2025-0110
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: