Active NPI
Mary Ruhl, LICSW
- Clinical Social Worker
- Medford, MA
National Provider Identifier
1548866825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 121456
- Practice address
- 9 Johnson Ave
Medford, MA 02155-1400 - Phone
- (617) 968-7586
- NPI assigned
- Dec 10, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 121456 | MA | Primary |
Addresses
Primary practice location
9 Johnson Ave
Medford, MA 02155-1400
Mailing address
9 Johnson Ave
Medford, MA 02155-1400
Phone (617) 968-7586
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 121456 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607558400000",
"number": "1548866825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 JOHNSON AVE",
"city": "MEDFORD",
"state": "MA",
"postal_code": "021551400",
"telephone_number": "617-968-7586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 JOHNSON AVE",
"city": "MEDFORD",
"state": "MA",
"postal_code": "021551400",
"telephone_number": "617-968-7586"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUHL",
"first_name": "MARY",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-10",
"last_updated": "2020-12-10",
"certification_date": "2020-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "121456",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.