Individual
DANIELLE RUCHAEVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
655 E JERSEY ST, BEHAVIORAL HEALTH, ELIZABETH, NJ 07206-1259
(908) 994-5000
Mailing address
655 E JERSEY ST, BEHAVIORAL HEALTH, ELIZABETH, NJ 07206-1259
(908) 994-5000
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
44SL05367200
NJ
1041C0700X
Clinical Social Worker
Primary
44SC05650500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44SC05650500
STATE LICENSE
NJ
01
—
44SL05367200
STATE LICENSE
NJ
Enumeration date
08/31/2007
Last updated
02/23/2016
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