Healthcare Provider Details

I. General information

NPI: 1386565315
Provider Name (Legal Business Name): PROVEN PATH COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 SOUTH DR
YARDLEY PA
19067-3101
US

IV. Provider business mailing address

13 SOUTH DR
YARDLEY PA
19067-3101
US

V. Phone/Fax

Practice location:
  • Phone: 609-902-8488
  • Fax:
Mailing address:
  • Phone: 609-902-8488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: PETER RUFFINI
Title or Position: OWNER
Credential:
Phone: 609-902-8488