Provider Demographics
NPI:1245396282
Name:LALLIER, RUTH P (LCSW)
Entity type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:P
Last Name:LALLIER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 98
Mailing Address - Street 2:214 WALLENS HILL
Mailing Address - City:WINSTED
Mailing Address - State:CT
Mailing Address - Zip Code:06098-0098
Mailing Address - Country:US
Mailing Address - Phone:860-379-6015
Mailing Address - Fax:860-379-6016
Practice Address - Street 1:214 WALLENS HILL
Practice Address - Street 2:
Practice Address - City:WINSTED
Practice Address - State:CT
Practice Address - Zip Code:06098-0098
Practice Address - Country:US
Practice Address - Phone:860-379-6015
Practice Address - Fax:860-379-6016
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003085104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT140003085CT02OtherBCBS
CT186568OtherMHN
CT186568OtherMHN