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General NPI Number Information
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NPI Number | 1538673843
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Entity Type | Individual
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Provider Name | RUTA KERBELIS MA, LPC, LAC
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Gender | Female
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Dates
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Enumeration Date | 11/22/2017
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 6350 QUITMAN CT
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City | ARVADA
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State | CO
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Zip | 80003-6750
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Country | US
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Telephone | 303-884-3425
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Fax |
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Provider Business Mailing Address
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Address Line | 1 KALISA WAY STE 101
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City | PARAMUS
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State | NJ
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Zip | 07652-3508
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Country | US
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Telephone | 888-948-6789
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Fax | 877-345-3501
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ACD.0001356
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License Number State | CO
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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 | NLC.0013526
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC.0016138
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License Number State | CO
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