Provider Demographics
NPI:1003316480
Name:RUMBLE, CAROLE (CASAC)
Entity Type:Individual
Prefix:MISS
First Name:CAROLE
Middle Name:
Last Name:RUMBLE
Suffix:
Gender:F
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-3312
Mailing Address - Country:US
Mailing Address - Phone:845-486-8880
Mailing Address - Fax:845-486-8885
Practice Address - Street 1:412 MAIN ST
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-3312
Practice Address - Country:US
Practice Address - Phone:845-486-8880
Practice Address - Fax:845-486-8885
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-13
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty