Provider Demographics
NPI:1548648132
Name:RUGEMER, JOHN M (LCPC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:RUGEMER
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E MASON ST
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-5730
Mailing Address - Country:US
Mailing Address - Phone:406-579-8579
Mailing Address - Fax:
Practice Address - Street 1:333 HAGGERTY LN
Practice Address - Street 2:SUITE 9
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-1779
Practice Address - Country:US
Practice Address - Phone:406-579-8579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-14
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSWP-LCPC-LIC-12015101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health