Provider Demographics
NPI:1720210610
Name:GARDNER-WHELAN, RUTH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:
Last Name:GARDNER-WHELAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:RUTH
Other - Middle Name:
Other - Last Name:WHELAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:2316 GRANDVIEW RD
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-9344
Mailing Address - Country:US
Mailing Address - Phone:484-716-3971
Mailing Address - Fax:
Practice Address - Street 1:129 CHARLES ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1807
Practice Address - Country:US
Practice Address - Phone:717-633-1227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0161541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical