Provider Demographics
NPI:1174284624
Name:EUDY, RUTH L (LCSW)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:L
Last Name:EUDY
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 1:2106 S GAINES ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72206-1319
Mailing Address - Country:US
Mailing Address - Phone:501-580-3335
Mailing Address - Fax:
Practice Address - Street 1:1323 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-4843
Practice Address - Country:US
Practice Address - Phone:501-580-3335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR8202-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical