Provider Demographics
NPI:1164561262
Name:RUBERG, CYNTHIA LIEF (MS ED, LPCC)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LIEF
Last Name:RUBERG
Suffix:
Gender:F
Credentials:MS ED, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30645
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-0645
Mailing Address - Country:US
Mailing Address - Phone:614-865-1612
Mailing Address - Fax:614-475-0807
Practice Address - Street 1:167 S STATE ST
Practice Address - Street 2:STE 110
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2265
Practice Address - Country:US
Practice Address - Phone:614-865-1612
Practice Address - Fax:614-475-0807
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-2675101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health