Provider Demographics
NPI:1104853779
Name:FOLCHMAN, RUTH (PSYD, CGP)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:
Last Name:FOLCHMAN
Suffix:
Gender:F
Credentials:PSYD, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3005
Mailing Address - Country:US
Mailing Address - Phone:413-582-6900
Mailing Address - Fax:413-582-6955
Practice Address - Street 1:40 CENTER ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3005
Practice Address - Country:US
Practice Address - Phone:413-582-6900
Practice Address - Fax:413-582-6955
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8568103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1300881Medicaid