RYAN RUTKOWSKI NPI 1053800979

NPI Information

  • NPI: 1053800979
  • Provider Name: RYAN RUTKOWSKI
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 505 BREVARD AVE
    COCOA, FL
    ZIP 32922
  • Phone: (579) 232-1632

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NPI Details

Ryan Rutkowski is a mental health counselor in Cocoa, FL. Ryan Rutkowski NPI is 1053800979. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

505 BREVARD AVE
COCOA, FL
ZIP 32922-973
Phone: (579) 232-1632

The NPI 1053800979 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 5/7/2018 and was last updated on 9/2/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11041C0700XSocial WorkerClinical6801106905MICHIGANNo
21041C0700XSocial WorkerClinical6851106905MICHIGANNo
31041C0700XSocial WorkerClinical6801114905MICHIGANNo
41041C0700XSocial WorkerClinicalSW20818FLORIDANo
5101YM0800XCounselorMental HealthSW20818FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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