Provider Demographics
NPI:1114308525
Name:RUBIN, EMILY (LCSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:RUBIN
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 1:439 9TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4111
Mailing Address - Country:US
Mailing Address - Phone:845-202-0652
Mailing Address - Fax:
Practice Address - Street 1:439 9TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4111
Practice Address - Country:US
Practice Address - Phone:845-202-0652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-11
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY084204104100000X
NY0838531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
WI331945Medicare Oscar/Certification
WI331978Medicare Oscar/Certification
NYG100000410Medicare Oscar/Certification
WI331952Medicare Oscar/Certification
NY00695941Medicaid
WI331048Medicare Oscar/Certification
WI331954Medicare Oscar/Certification
WI331946Medicare Oscar/Certification
WI331058Medicare Oscar/Certification
WI331943Medicare Oscar/Certification
WI331944Medicare Oscar/Certification
NYW6L111Medicare Oscar/Certification
WI331009Medicare Oscar/Certification