Provider Demographics
NPI:1417022930
Name:RUIZ, SUSAN (LSCSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:RUIZ
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 1:757 ARMSTRONG AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66101-2701
Mailing Address - Country:US
Mailing Address - Phone:913-233-3300
Mailing Address - Fax:913-233-3350
Practice Address - Street 1:757 ARMSTRONG AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66101-2701
Practice Address - Country:US
Practice Address - Phone:913-233-3300
Practice Address - Fax:913-233-3350
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLSCSW 20311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical