Provider Demographics
NPI:1801383435
Name:COFFEY, RUTH ELLEN (LCSW)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:ELLEN
Last Name:COFFEY
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 569
Mailing Address - Street 2:
Mailing Address - City:RANGELEY
Mailing Address - State:ME
Mailing Address - Zip Code:04970-0569
Mailing Address - Country:US
Mailing Address - Phone:207-864-2699
Mailing Address - Fax:207-864-2969
Practice Address - Street 1:LOVEJOY HEALTH CENTER
Practice Address - Street 2:7 SCHOOL ST SUITE 1
Practice Address - City:ALBION
Practice Address - State:ME
Practice Address - Zip Code:04910
Practice Address - Country:US
Practice Address - Phone:207-437-9388
Practice Address - Fax:207-437-2557
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC129021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical