Provider Demographics
NPI:1376115436
Name:RUFF, SARAH ROSE (LLMSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ROSE
Last Name:RUFF
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3915 CROOKS RD APT 23
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-2453
Mailing Address - Country:US
Mailing Address - Phone:586-216-5023
Mailing Address - Fax:
Practice Address - Street 1:3915 CROOKS RD APT 23
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-2453
Practice Address - Country:US
Practice Address - Phone:586-216-5023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011098751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical