MEDICARE: MS. RUTH COOKE HART LCSW,MFT,CAP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	2582	FL
2	1041C0700X	Clinical Social Worker	0002531	FL
3	106H00000X	Marriage & Family Therapist	0001357	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Z020K	OTHER	FL	BLUE CROSS

General Provider Information

NPI Number	:	1588869630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RUTH COOKE HART LCSW,MFT,CAP

Provider Business Mailing Address
First Line	:	1303 MIRROR TER NW
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33881-2352
Country	:	US
Telephone Number	:	863-258-1203
Fax Number	:	863-292-2201

Provider Business Practice Location Address
First Line	:	630 POPE AVE NW
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33881-4665
Country	:	US
Telephone Number	:	863-292-2201
Fax Number	:	863-292-2201

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2007
Last Update Date	:	09/11/2025

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