Healthcare Provider Details

I. General information

NPI: 1619980422
Provider Name (Legal Business Name): RUTH RINCKER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2118 YORKTOWN S
JEFFERSONVILLE PA
19403-3537
US

IV. Provider business mailing address

2118 YORKTOWN S
JEFFERSONVILLE PA
19403-3537
US

V. Phone/Fax

Practice location:
  • Phone: 610-630-1320
  • Fax:
Mailing address:
  • Phone: 610-630-1320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW013978
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: