Provider Demographics
NPI:1730252313
Name:GRILL, RUTH MARION (LCSW MSW)
Entity type:Individual
Prefix:MS
First Name:RUTH
Middle Name:MARION
Last Name:GRILL
Suffix:
Gender:F
Credentials:LCSW MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 KENT AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10706-3202
Mailing Address - Country:US
Mailing Address - Phone:914-478-1660
Mailing Address - Fax:914-478-1660
Practice Address - Street 1:10 KENT AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10706-3202
Practice Address - Country:US
Practice Address - Phone:914-478-1660
Practice Address - Fax:914-478-1660
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR001800911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN21481Medicare ID - Type Unspecified