Provider Demographics
NPI:1538763123
Name:MOTTA, RUTH LOUISE (LPC, LLP)
Entity type:Individual
Prefix:DR
First Name:RUTH
Middle Name:LOUISE
Last Name:MOTTA
Suffix:
Gender:F
Credentials:LPC, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5123 JESSICA JOY ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-4775
Mailing Address - Country:US
Mailing Address - Phone:702-806-1356
Mailing Address - Fax:
Practice Address - Street 1:5123 JESSICA JOY ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-4775
Practice Address - Country:US
Practice Address - Phone:702-806-1356
Practice Address - Fax:702-331-2184
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401002809101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional