Provider Demographics
NPI:1013380005
Name:SUDILOVSKY-PECHA, RUTH (LISW-S)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:SUDILOVSKY-PECHA
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 SUPERIOR AVE E
Mailing Address - Street 2:#1400
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114-1902
Mailing Address - Country:US
Mailing Address - Phone:216-619-6194
Mailing Address - Fax:
Practice Address - Street 1:526 SUPERIOR AVE E
Practice Address - Street 2:#1400
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-1902
Practice Address - Country:US
Practice Address - Phone:216-619-6194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00074751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical