Provider Demographics
NPI:1437657558
Name:EMERSON, RUTH ELLEN (LCSW)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:ELLEN
Last Name:EMERSON
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 1:1172 S MAIN ST # 125
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2204
Mailing Address - Country:US
Mailing Address - Phone:800-214-5439
Mailing Address - Fax:831-796-0334
Practice Address - Street 1:252 SAN JOSE ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3901
Practice Address - Country:US
Practice Address - Phone:800-214-5439
Practice Address - Fax:831-796-0334
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA642931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical