MEDICARE: SHARON DENISE RUTLEDGE LMSW

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	1041C0700X	Clinical Social Worker	6802070572	MI

General Provider Information

NPI Number	:	1891852687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON DENISE RUTLEDGE LMSW

Provider Business Mailing Address
First Line	:	3534 DICKERSON ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48215-2486
Country	:	US
Telephone Number	:	313-492-2745
Fax Number	:	313-824-2668

Provider Business Practice Location Address
First Line	:	3534 DICKERSON ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48215-2486
Country	:	US
Telephone Number	:	313-492-2745
Fax Number	:	313-824-2668

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

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	10/27/2023

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