Provider Demographics
NPI:1164644324
Name:RUBIN, JEFFREY (LCSW-R)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:RUBIN
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W 85TH ST
Mailing Address - Street 2:APT.#11C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3907
Mailing Address - Country:US
Mailing Address - Phone:212-580-4326
Mailing Address - Fax:
Practice Address - Street 1:201 W 85TH ST
Practice Address - Street 2:APT.#11C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3907
Practice Address - Country:US
Practice Address - Phone:212-580-4326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR040628-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical