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General NPI Number Information
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NPI Number | 1336384890
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Entity Type | Individual
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Provider Name | JEANNE ANN RUTH LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/11/2008
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Last Update Date | 12/11/2008
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Provider Practice Location Address
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Address Line | 52 WASHINGTON ST
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City | RENSSELAER
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State | NY
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Zip | 12144-2834
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Country | US
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Telephone | 518-486-7511
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Fax | 518-402-2704
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Provider Business Mailing Address
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Address Line | 73 ACADEMY RD
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City | ALBANY
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State | NY
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Zip | 12208-3104
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Country | US
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Telephone | 518-542-7167
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Fax | 518-402-7204
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 053551-1
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License Number State | NY
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