Provider Type Icon

DR. LAURIE FAIRALL-RUETER LLC NPI 1669795761


NPI Information

NPI: 1669795761
Provider Name: DR. LAURIE FAIRALL-RUETER, LLC

Other Name: LAURIE FAIRALL-RUETER

Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
4400 MARSH LANDING BLVD
SUITE 1
PONTE VEDRA BEACH, FL
ZIP 32082
Phone: (904) 463-2284
Get Directions

DR. LAURIE FAIRALL-RUETER, LLC is a clinical psychologist in Ponte Vedra Beach, FL. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. DR. LAURIE FAIRALL-RUETER, LLC NPI is 1669795761. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Laurie Fairall-rueter.

The provider's business location address is:

4400 MARSH LANDING BLVD
SUITE 1
PONTE VEDRA BEACH, FL
ZIP 32082-287
Phone: (904) 463-2284
Fax: (904) 543-7755

The provider's authorized official is Laurie Fairall-rueter .
The authorized official title is Licensed Psychologist and has the following contact phone number (904) 463-2284.

The enumeration date for this NPI number is 3/4/2010 and was last updated on 4/17/2014.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC0700XPsychologistClinical36593TEXASNo
2103TC0700XPsychologistClinicalPY003739GEORGIANo
3103TC0700XPsychologistClinicalPY 7675FLORIDAYes

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.