Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Carlice Cecil Ruttan II, LCSW

Individual provider Clinical Social Worker · NPI 1740540129

Mr. Carlice Cecil Ruttan II, LCSW is a Clinical Social Worker in Watertown, New York. Qualified in 1995, 31 years ago. Practices with Thrive Wellness and Recovery Inc, a 9-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
31
Licensed in
NY
In the registry since
2012
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

165 Coleman Ave
Watertown, NY 13601-2217
Phone: (315) 782-2061
Fax: (315) 788-1529
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 079048-1 (NY)

Record details

NPI number1740540129
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedMay 21, 2012
Last updated in NPPESMay 21, 2012

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1995 (31 years in practice)
Group practice Thrive Wellness And Recovery Inc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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