Provider Demographics
NPI:1861947731
Name:PAUL R. RUSCITO, L.P.C., PLLC
Entity type:Organization
Organization Name:PAUL R. RUSCITO, L.P.C., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:RUSCITO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:540-466-0459
Mailing Address - Street 1:106 OXFORD CT
Mailing Address - Street 2:
Mailing Address - City:STEPHENS CITY
Mailing Address - State:VA
Mailing Address - Zip Code:22655-3411
Mailing Address - Country:US
Mailing Address - Phone:540-466-0459
Mailing Address - Fax:
Practice Address - Street 1:311 S LOUDOUN ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-4637
Practice Address - Country:US
Practice Address - Phone:540-466-0459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-22
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004804101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty