MEDICARE: RUTH SALEN LCSW

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	104100000X	Social Worker	093540	NY
2	1041C0700X	Clinical Social Worker	093540	NY
3	1041C0700X	Clinical Social Worker	089126-01	NY

General Provider Information

NPI Number	:	1881942019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUTH SALEN LCSW

Provider Business Mailing Address
First Line	:	462 1ST AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-9196
Country	:	US
Telephone Number	:	999-999-9999
Fax Number	:

Provider Business Practice Location Address
First Line	:	2702 BROADWAY
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10025-8701
Country	:	US
Telephone Number	:	999-999-9999
Fax Number	:

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

Provider Enumeration Date	:	08/20/2012
Last Update Date	:	11/13/2021

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Directions to “ RUTH SALEN LCSW” Practice Location

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