MEDICARE: RUTH BRINKERHOFF COUNSELING AND ASSESSMENT LLC

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	688L	NV
2	103TS0200X	School Psychologist	32863	NV
3	106H00000X	Marriage & Family Therapist	MI0466	NV

General Provider Information

NPI Number	:	1881025922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUTH BRINKERHOFF COUNSELING AND ASSESSMENT LLC

Provider Business Mailing Address
First Line	:	11295 CORNERBROOK CT
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-9221
Country	:	US
Telephone Number	:	775-772-3010
Fax Number	:

Provider Business Practice Location Address
First Line	:	180 W HUFFAKER LN
Second Line	:	SUITE 303
City	:	RENO
State	:	NV
Zip	:	89511-2346
Country	:	US
Telephone Number	:	775-772-3010
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	RUTH BRINKERHOFF
Credential	:
Telephone Number	:	775-772-3010

Provider Enumeration Date	:	11/27/2013
Last Update Date	:	07/07/2014

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