Provider Demographics
NPI:1417038167
Name:DOLIN, RUTH (LCSW)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:DOLIN
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 1:6800 BAUM DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-7315
Mailing Address - Country:US
Mailing Address - Phone:865-374-7152
Mailing Address - Fax:865-374-7155
Practice Address - Street 1:6800 BAUM DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-7315
Practice Address - Country:US
Practice Address - Phone:865-374-7152
Practice Address - Fax:865-374-7155
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLCSW43681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3989948Medicare ID - Type Unspecified