Provider Demographics
NPI:1164304531
Name:RUEHL, AUTUMN R (CSW)
Entity type:Individual
Prefix:
First Name:AUTUMN
Middle Name:R
Last Name:RUEHL
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:AUTUMN
Other - Middle Name:R
Other - Last Name:STANTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3629 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41015-1430
Mailing Address - Country:US
Mailing Address - Phone:859-426-1313
Mailing Address - Fax:
Practice Address - Street 1:3629 CHURCH ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41015-1430
Practice Address - Country:US
Practice Address - Phone:859-426-1313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2602301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical