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General NPI Number Information
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NPI Number | 1649063934
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Entity Type | Organization
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Legal Business Name | NOR CAL RURAL THERAPY A LPCC CORPORATION
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 600 F STREET, STE 3 #725
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City | ARCATA
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State | CA
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Zip | 95521
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Country | US
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Telephone | 707-278-6658
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Fax |
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Provider Business Mailing Address
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Address Line | 600 F STREET, STE 3 #725
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City | ARCATA
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State | CA
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Zip | 95521
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Country | US
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Telephone | 707-278-6658
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MILES RUTTINGER
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Credential | LMFT
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Telephone | 707-278-6658
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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