Provider Demographics
NPI:1609027739
Name:CAMPBELL, RUTH K (LISW)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:K
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:MRS
Other - First Name:RUTH
Other - Middle Name:K
Other - Last Name:O'BRIEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:601 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-2501
Mailing Address - Country:US
Mailing Address - Phone:515-244-3761
Mailing Address - Fax:515-237-5070
Practice Address - Street 1:601 GRAND AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-2501
Practice Address - Country:US
Practice Address - Phone:515-244-3761
Practice Address - Fax:515-237-5070
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA005161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical