Provider Demographics
NPI:1811874068
Name:RUDERMAN, TOVA (MS, LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:TOVA
Middle Name:
Last Name:RUDERMAN
Suffix:
Gender:F
Credentials:MS, LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4060 BEACON SQUARE BLVD APT 222
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-5202
Mailing Address - Country:US
Mailing Address - Phone:214-317-5691
Mailing Address - Fax:
Practice Address - Street 1:5512 W PLANO PKWY STE 300
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4840
Practice Address - Country:US
Practice Address - Phone:469-626-9033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99870101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health