Provider Demographics
NPI:1194814061
Name:STEIN, RUTH (LCSW)
Entity type:Individual
Prefix:MS
First Name:RUTH
Middle Name:
Last Name:STEIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2151 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3642
Mailing Address - Country:US
Mailing Address - Phone:718-633-7914
Mailing Address - Fax:718-633-3484
Practice Address - Street 1:2151 E 22ND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3642
Practice Address - Country:US
Practice Address - Phone:718-633-7914
Practice Address - Fax:718-633-3484
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR013797-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP2544976OtherOXFORD
NY740-0540OtherGHI-BMP
NY162025POtherHIP
NY144820OtherVALUE OPTIONS
NY2085680OtherCIGNA
NYP2544976OtherOXFORD