Provider Demographics
NPI:1073028056
Name:RUFF, LISA (LSCSW)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:
Last Name:RUFF
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 COLLEGE BLVD STE 111
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1626
Mailing Address - Country:US
Mailing Address - Phone:913-703-4055
Mailing Address - Fax:
Practice Address - Street 1:5401 COLLEGE BLVD STE 111
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1626
Practice Address - Country:US
Practice Address - Phone:913-703-4055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-12
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4845104100000X
KS50931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker