Provider Demographics
NPI:1992841761
Name:STOLTZFUS, RUTH ANN (MSW-LCSW-C)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:ANN
Last Name:STOLTZFUS
Suffix:
Gender:F
Credentials:MSW-LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8607 2ND AVE
Mailing Address - Street 2:SUITE 407-A
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3355
Mailing Address - Country:US
Mailing Address - Phone:301-565-5920
Mailing Address - Fax:
Practice Address - Street 1:8607 2ND AVE
Practice Address - Street 2:SUITE 407-A
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3355
Practice Address - Country:US
Practice Address - Phone:301-587-0737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05185101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD654490Medicare PIN