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General NPI Number Information
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NPI Number | 1407183841
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Entity Type | Organization
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Legal Business Name | RUTH RADER LCSW LLC
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Dates
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Enumeration Date | 11/05/2009
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Last Update Date | 11/05/2009
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Provider Practice Location Address
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Address Line | 8935 N MERIDIAN ST SUITE 107
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-5379
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Country | US
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Telephone | 317-571-0171
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Fax | 317-571-2005
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Provider Business Mailing Address
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Address Line | 9425 N MERIDIAN ST #280
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-1308
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Country | US
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Telephone | 317-571-0171
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Fax | 317-571-2005
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Authorized Official
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Title or Position | OWNER
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Name | RUTH RADER
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Credential | LCSW
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Telephone | 317-571-0171
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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 | 34004455A
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License Number State | IN
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