Healthcare Provider Details

I. General information

NPI: 1881367035
Provider Name (Legal Business Name): AMY LYNN MCDEVITT RUGGIERO LCSW, JD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2021
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 W LANCASTER AVE
BRYN MAWR PA
19010-3229
US

IV. Provider business mailing address

1045 MORGAN AVE
DREXEL HILL PA
19026-3318
US

V. Phone/Fax

Practice location:
  • Phone: 610-787-2882
  • Fax:
Mailing address:
  • Phone: 610-787-2882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW025918
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: