Provider Demographics
NPI:1902964158
Name:MUMFORD, RUTH SHARI (LCSW)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:SHARI
Last Name:MUMFORD
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 335
Mailing Address - Street 2:
Mailing Address - City:MENDHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07945-0335
Mailing Address - Country:US
Mailing Address - Phone:973-543-0500
Mailing Address - Fax:
Practice Address - Street 1:5 COLD HILL RD S STE 18
Practice Address - Street 2:
Practice Address - City:MENDHAM
Practice Address - State:NJ
Practice Address - Zip Code:07945-3208
Practice Address - Country:US
Practice Address - Phone:973-543-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC000015001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical