Individual provider Active NPI

Ruth Catherine Kenrick, M.A., L.I. C.S.W.

  • Clinical Social Worker
  • Green Valley, AZ
National Provider Identifier
1003982034
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089.0077060 Issued in VT
Practice address
135 S Paseo Tierra Apt a
Green Valley, AZ 85614-7408
Phone
(802) 258-7621
Fax
(520) 355-7672
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4932 NH
Clinical Social Worker 1041C0700X 089.0077060 VT Primary
Clinical Social Worker 1041C0700X 073803-1 NY

Addresses

Primary practice location

135 S Paseo Tierra Apt a
Green Valley, AZ 85614-7408

Mailing address

135 S Paseo Tierra Apt a
Green Valley, AZ 85614-7408
Phone (802) 258-7621

Other practice location 1

289 Main St
Norwich, VT 05055-9352
Phone (802) 258-7621

Other identifiers 2

IdentifierTypeStateIssuer
089.0077060OtherVTLICSW
073803-1OtherNYLCSW LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200423000478 VT Practitioner - Clinical Social Worker 5193825891 Practice locations: Brattleboro, VT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
4932NHMDClinical Social Worker
073803-1NYMDClinical Social Worker
089.0077060VTMDClinical Social Worker
073803NYMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1003982034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 S PASEO TIERRA APT A",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856147408",
            "telephone_number": "802-258-7621",
            "fax_number": "520-355-7672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S PASEO TIERRA APT A",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856147408",
            "telephone_number": "802-258-7621",
            "fax_number": "520-355-7672"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "289 Main St",
            "address_purpose": "LOCATION",
            "city": "Norwich",
            "state": "VT",
            "postal_code": "050559352",
            "country_code": "US",
            "telephone_number": "802-258-7621",
            "fax_number": "520-355-7672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENRICK",
        "first_name": "RUTH",
        "middle_name": "CATHERINE",
        "name_prefix": "Ms.",
        "credential": "M.A., L.I. C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "4932",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089.0077060",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "073803-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICSW",
            "identifier": "089.0077060",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW LICENSE NUMBER",
            "identifier": "073803-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Valley, AZ

Sources for this page

Verify at the official NPI Registry.