Healthcare Provider Details

I. General information

NPI: 1851733315
Provider Name (Legal Business Name): RUTH E MCKINNEY LPCC-S, LICDC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2013
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3545 LINCOLN WAY E STE B
MASSILLON OH
44646-8624
US

IV. Provider business mailing address

4600 MONTGOMERY RD
CINCINNATI OH
45212-2697
US

V. Phone/Fax

Practice location:
  • Phone: 513-834-7063
  • Fax: 513-873-1567
Mailing address:
  • Phone: 833-510-4357
  • Fax: 866-460-2997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE1200105SUPV
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLICDC141045
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLICDC.141045
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: