Provider Demographics
NPI:1053735779
Name:RUDDEN COUNSELING SERVICES
Entity type:Organization
Organization Name:RUDDEN COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RUDDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP, LPC
Authorized Official - Phone:773-308-3320
Mailing Address - Street 1:PO BOX 11652
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-0652
Mailing Address - Country:US
Mailing Address - Phone:303-482-6687
Mailing Address - Fax:
Practice Address - Street 1:9351 GRANT ST
Practice Address - Street 2:SUITE 480
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4358
Practice Address - Country:US
Practice Address - Phone:303-482-6687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-17
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6090251S00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO13707736Medicaid