Provider Demographics
NPI:1073771010
Name:LIPSCOMB, RUBY DELORES (PHD, MSW, LISW)
Entity Type:Individual
Prefix:DR
First Name:RUBY
Middle Name:DELORES
Last Name:LIPSCOMB
Suffix:
Gender:F
Credentials:PHD, MSW, LISW
Other - Prefix:DR
Other - First Name:RUBY
Other - Middle Name:COOPER
Other - Last Name:LIPSCOMB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, MSW, LISW
Mailing Address - Street 1:393 E TOWN ST
Mailing Address - Street 2:212
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-4741
Mailing Address - Country:US
Mailing Address - Phone:614-214-8113
Mailing Address - Fax:614-841-9625
Practice Address - Street 1:393 E TOWN ST
Practice Address - Street 2:212
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4741
Practice Address - Country:US
Practice Address - Phone:614-214-8113
Practice Address - Fax:614-841-9625
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH00017601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical