Provider Demographics
NPI:1417375676
Name:HAMSHAR, RUTH (CAC III)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:HAMSHAR
Suffix:
Gender:F
Credentials:CAC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5091
Mailing Address - Street 2:
Mailing Address - City:BUENA VISTA
Mailing Address - State:CO
Mailing Address - Zip Code:81211-5091
Mailing Address - Country:US
Mailing Address - Phone:719-258-0898
Mailing Address - Fax:
Practice Address - Street 1:448 E 1ST ST
Practice Address - Street 2:SUITE 224
Practice Address - City:SALIDA
Practice Address - State:CO
Practice Address - Zip Code:81201-2804
Practice Address - Country:US
Practice Address - Phone:719-207-4163
Practice Address - Fax:719-745-7000
Is Sole Proprietor?:No
Enumeration Date:2014-04-03
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6089101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)