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Ruth Yadira Haddock

Counselor

Behavioral Health & Social Service Providers

PECOS Enrollment

This provider is enrolled in PECOS as RUTH HADDOCK.

Based on the most recent information from CMS, provider Ruth Yadira Haddock is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1194262972
Provider Type
Individual
Full Name
Haddock, Ruth Yadira
Gender
Female

Sole Proprietor
No
Enumeration Date
1/31/2017
Last Updated
6/26/2023

Contact Information

Practice Location

235 Maple St, Holyoke, MA 01040

(413) 532-0389

(413) 532-1548

Mailing Location

235 Maple St, Holyoke, MA 01040-5117

(413) 532-0389

(413) 532-1548

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer

Provider Identifiers

ID	Description	Issuer
ID 1194262972	Description Medicaid	Issuer Unlisted Massachusetts

Ruth Yadira Haddock

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Mcintyre, Sarah A

Sousse, Bernard Joseph

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Soale Fuseini, Mahani

Lewis, Andrew

Toomey, Monica F.

Marsh, Michael Anthony

Ledoux, Lauren

Swanson, Alex Mcgoldrick

Garces, Yolanda