Provider Demographics
NPI:1336384890
Name:RUTH, JEANNE ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:ANN
Last Name:RUTH
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 1:73 ACADEMY RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3104
Mailing Address - Country:US
Mailing Address - Phone:518-542-7167
Mailing Address - Fax:518-402-7204
Practice Address - Street 1:52 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:NY
Practice Address - Zip Code:12144-2834
Practice Address - Country:US
Practice Address - Phone:518-486-7511
Practice Address - Fax:518-402-2704
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053551-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical