Provider Demographics
NPI:1033509187
Name:GERHART, RUTH EDITH (LCSW)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:EDITH
Last Name:GERHART
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 1:501 ELLA AVE
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60433-2799
Mailing Address - Country:US
Mailing Address - Phone:815-740-5529
Mailing Address - Fax:
Practice Address - Street 1:501 ELLA AVE
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60433-2799
Practice Address - Country:US
Practice Address - Phone:815-740-5529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-28
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0162221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical