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General NPI Number Information
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NPI Number | 1346858578
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Entity Type | Individual
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Provider Name | JESSICA RUIZ LCMHC, LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 07/14/2020
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 1593 SPRING HILL RD STE 705
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City | VIENNA
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State | VA
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Zip | 22182-2289
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Country | US
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Telephone | 704-844-3620
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Fax |
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Provider Business Mailing Address
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Address Line | 1593 SPRING HILL RD STE 705
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City | VIENNA
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State | VA
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Zip | 22182-2289
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Country | US
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Telephone | 804-207-6737
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701013270
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 15756
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License Number State | NC
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