Provider Demographics
NPI:1396758702
Name:KEITH, RUTH E (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:RUTH
Middle Name:E
Last Name:KEITH
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 SEILER AVE
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-9239
Mailing Address - Country:US
Mailing Address - Phone:912-236-6811
Mailing Address - Fax:912-236-6811
Practice Address - Street 1:325 W MONTGOMERY XRD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3309
Practice Address - Country:US
Practice Address - Phone:912-920-0214
Practice Address - Fax:912-921-2000
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0027261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical