Provider Demographics
NPI:1487736237
Name:SAUL, RUTH ELLEN NMI (LCSW)
Entity type:Individual
Prefix:MS
First Name:RUTH ELLEN
Middle Name:NMI
Last Name:SAUL
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 1:5600 MEDICAL CIR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1243
Mailing Address - Country:US
Mailing Address - Phone:608-469-8181
Mailing Address - Fax:608-467-8010
Practice Address - Street 1:5600 MEDICAL CIR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1243
Practice Address - Country:US
Practice Address - Phone:608-469-8181
Practice Address - Fax:608-467-8010
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2677-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI079349OtherGROUP HEALTH COOPERATIVE SCW
WI002084027OtherMEDICARE
WI39632400Medicaid
WI002084027Medicare PIN