Provider Demographics
NPI:1922443993
Name:WHELLER, RUTH (EDS, LPC)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:WHELLER
Suffix:
Gender:F
Credentials:EDS, LPC
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:
Other - Last Name:WHEELER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:912 POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-3852
Mailing Address - Country:US
Mailing Address - Phone:870-530-5739
Mailing Address - Fax:844-908-2206
Practice Address - Street 1:1000 S CARAWAY RD STE 103
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4465
Practice Address - Country:US
Practice Address - Phone:870-530-5739
Practice Address - Fax:844-908-2206
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1701225101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional