MAXINE A RUDDOCK PHD P A NPI 1578732632

NPI Information

  • NPI: 1578732632
  • Provider Name: MAXINE A RUDDOCK PHD P A
  • Classification: Community/Behavioral Health - 251S00000X
  • Entity Type: Organization
  • Doing Business As: COMPREHENSIVE PSYCHOLOGICAL & ASSESSMENT SERVICES
  • Address: 2511 DORA AVE
    TAVARES, FL
    ZIP 32778
  • Phone: (352) 508-5399

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NPI Details

MAXINE A RUDDOCK PHD P A is a community behavioral health in Tavares, FL. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. MAXINE A RUDDOCK PHD P A NPI is 1578732632. The provider is registered as an organization entity type.
The provider Is Doing Business As Comprehensive Psychological & Assessment Services.

The provider's business location address is:

2511 DORA AVE
TAVARES, FL
ZIP 32778-977
Phone: (352) 508-5399
Fax: (917) 677-7121

The provider's authorized official is Maxine A Ruddock .
The authorized official title is Director and has the following contact phone number (352) 508-5399.

The enumeration date for this NPI number is 2/22/2008 and was last updated on 4/27/2015.

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
1251B00000XCase ManagementPY7658FLORIDANo
2251S00000XCommunity/Behavioral HealthPY7658FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1AJ660BMEDICARE UPINFLORIDA
2004100303MEDICAIDFLORIDA
3004100300MEDICAIDFLORIDA
4008487400MEDICAIDFLORIDA

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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