Provider Demographics
NPI:1235286592
Name:WOODMANSEE, RUTH (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:WOODMANSEE
Suffix:
Gender:F
Credentials:MSW, LICSW
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 17
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:RI
Mailing Address - Zip Code:02812-0017
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1362
Practice Address - Country:US
Practice Address - Phone:401-737-0820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW0002211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI6270231OtherUNITED HEALTH
RI23937-8OtherBLUE CROSS
RI406887OtherBLUE CHIP
RIFM49368Medicaid
RI1023290OtherBEACON HEALTH STRATEGIES