Provider Demographics
NPI:1619715737
Name:RUTH, LAUREN KATHARINE (PHD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:KATHARINE
Last Name:RUTH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 TILTON ST FL 3
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-3543
Mailing Address - Country:US
Mailing Address - Phone:630-776-2630
Mailing Address - Fax:
Practice Address - Street 1:26 TILTON ST FL 3
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-3543
Practice Address - Country:US
Practice Address - Phone:630-776-2630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist