Provider Demographics
NPI:1104849934
Name:RUBENFELD, MONA I (MA, LCPC)
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:I
Last Name:RUBENFELD
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11447 CRONHILL DR
Mailing Address - Street 2:SUITE L
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-2286
Mailing Address - Country:US
Mailing Address - Phone:410-960-3954
Mailing Address - Fax:
Practice Address - Street 1:11447 CRONHILL DR
Practice Address - Street 2:SUITE L
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-2286
Practice Address - Country:US
Practice Address - Phone:410-960-3954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2185101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional