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General NPI Number Information
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NPI Number | 1730888678
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Entity Type | Individual
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Provider Name | MICHAEL RUGULEISKI LPC
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Gender | Male
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Dates
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Enumeration Date | 02/28/2023
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 3800 FOREST DR STE A205
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City | COLUMBIA
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State | SC
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Zip | 29204-4146
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Country | US
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Telephone | 803-542-9603
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Fax |
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Provider Business Mailing Address
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Address Line | 246 COLUMBIA CLUB DR E
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City | BLYTHEWOOD
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State | SC
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Zip | 29016-9479
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Country | US
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Telephone | 803-240-1967
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 7934
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License Number State | SC
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