Provider Demographics
NPI:1891852687
Name:RUTLEDGE, SHARON DENISE (LMSW)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:DENISE
Last Name:RUTLEDGE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3534 DICKERSON ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48215-2486
Mailing Address - Country:US
Mailing Address - Phone:313-492-2745
Mailing Address - Fax:313-824-2668
Practice Address - Street 1:3534 DICKERSON ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48215-2486
Practice Address - Country:US
Practice Address - Phone:313-492-2745
Practice Address - Fax:313-824-2668
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68020705721041C0700X, 101YP2500X, 1041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional