Healthcare Provider Details

I. General information

NPI: 1609136498
Provider Name (Legal Business Name): JOSEPH JAMES RUGGEBEREG LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2012
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 LEBANON RD
MURFREESBORO TN
37129-1392
US

IV. Provider business mailing address

8035 VALLEYVIEW DR
YPSILANTI MI
48197-8359
US

V. Phone/Fax

Practice location:
  • Phone: 615-867-6000
  • Fax:
Mailing address:
  • Phone: 515-708-5257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6810194104
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: