Provider Demographics
NPI:1659496768
Name:RUH, ELIZABETH L (LPCC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:L
Last Name:RUH
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 8970
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-0970
Mailing Address - Country:US
Mailing Address - Phone:419-475-4449
Mailing Address - Fax:419-517-1399
Practice Address - Street 1:2109 HUGHES DR
Practice Address - Street 2:JOBST TOWER #640
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3856
Practice Address - Country:US
Practice Address - Phone:419-661-0505
Practice Address - Fax:419-291-6436
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0002780101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
188839-000OtherMAGELLAN HEALTH SERVICE