MEDICARE: MS. RUTH B HELFRICH LCSW-R

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	024617R	NY

General Provider Information

NPI Number	:	1457675092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RUTH B HELFRICH LCSW-R

Provider Business Mailing Address
First Line	:	875 W END AVE
Second Line	:	STE. # 1-B
City	:	NEW YORK
State	:	NY
Zip	:	10025-4919
Country	:	US
Telephone Number	:	212-749-8005
Fax Number	:

Provider Business Practice Location Address
First Line	:	163 W 125TH ST
Second Line	:	12TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10027-4436
Country	:	US
Telephone Number	:	212-961-8745
Fax Number	:	212-866-2760

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2010
Last Update Date	:	07/24/2014

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