Provider Demographics
NPI:1689464075
Name:SNODGRASS, RUTHANN (LSCSW, LCAC)
Entity type:Individual
Prefix:
First Name:RUTHANN
Middle Name:
Last Name:SNODGRASS
Suffix:
Gender:
Credentials:LSCSW, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 130TH AVE
Mailing Address - Street 2:
Mailing Address - City:LARNED
Mailing Address - State:KS
Mailing Address - Zip Code:67550-5150
Mailing Address - Country:US
Mailing Address - Phone:620-804-2175
Mailing Address - Fax:
Practice Address - Street 1:1675 130TH AVE
Practice Address - Street 2:
Practice Address - City:LARNED
Practice Address - State:KS
Practice Address - Zip Code:67550-5150
Practice Address - Country:US
Practice Address - Phone:620-804-2175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS686101YA0400X
KS39281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)