Provider Demographics
NPI:1154812915
Name:RUBIN, DEBORAH FLORENCE (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:FLORENCE
Last Name:RUBIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DEBBY
Other - Middle Name:
Other - Last Name:FLORENCE, LLC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1017 HOLMES ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-2544
Mailing Address - Country:US
Mailing Address - Phone:140-623-9222
Mailing Address - Fax:
Practice Address - Street 1:1017 HOLMES ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-2544
Practice Address - Country:US
Practice Address - Phone:140-623-9222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-28
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCSW-LIC-305541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical