Provider Demographics
NPI:1518255199
Name:CONBOY, RUTH (LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:
Last Name:CONBOY
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1480 WINDSOR PARK LN
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-2706
Mailing Address - Country:US
Mailing Address - Phone:610-789-3833
Mailing Address - Fax:
Practice Address - Street 1:1480 WINDSOR PARK LN
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-2706
Practice Address - Country:US
Practice Address - Phone:610-789-3833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-15
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003658101YP2500X
PARN246886L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No163W00000XNursing Service ProvidersRegistered Nurse