Provider Demographics
NPI:1558981027
Name:RUTHERFORD-STEISS, DOROTHY ELLEN (PSYD, LMHC)
Entity Type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:ELLEN
Last Name:RUTHERFORD-STEISS
Suffix:
Gender:F
Credentials:PSYD, LMHC
Other - Prefix:DR
Other - First Name:DOROTHY
Other - Middle Name:ELLEN
Other - Last Name:STEISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD, MSED
Mailing Address - Street 1:9335 CALUMET AVENUE
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-4176
Mailing Address - Country:US
Mailing Address - Phone:219-513-8508
Mailing Address - Fax:219-513-9825
Practice Address - Street 1:9335 CALUMET AVENUE
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-4176
Practice Address - Country:US
Practice Address - Phone:219-513-8508
Practice Address - Fax:219-513-9825
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-24
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003357A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty