Provider Demographics
NPI:1124719794
Name:ROSENBERG, RUBY (LISW)
Entity type:Individual
Prefix:
First Name:RUBY
Middle Name:
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 SUNSET BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-1380
Mailing Address - Country:US
Mailing Address - Phone:216-302-8648
Mailing Address - Fax:
Practice Address - Street 1:1524 SUNSET BLVD STE A
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-1380
Practice Address - Country:US
Practice Address - Phone:216-302-8648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-16
Last Update Date:2025-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
OHI.25073591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHI2507359OtherSTATE