Provider Demographics
NPI:1174820872
Name:INTEGRATIVE MINDWORKS LLC, APRIL KING RUBINO SOLE MBR
Entity Type:Organization
Organization Name:INTEGRATIVE MINDWORKS LLC, APRIL KING RUBINO SOLE MBR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:KING
Authorized Official - Last Name:RUBINO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, CRC, CHT, RYT
Authorized Official - Phone:208-882-8159
Mailing Address - Street 1:803 S JEFFERSON ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MOSCOW
Mailing Address - State:ID
Mailing Address - Zip Code:83843-3096
Mailing Address - Country:US
Mailing Address - Phone:208-882-8159
Mailing Address - Fax:
Practice Address - Street 1:803 S JEFFERSON ST
Practice Address - Street 2:SUITE 3
Practice Address - City:MOSCOW
Practice Address - State:ID
Practice Address - Zip Code:83843-3096
Practice Address - Country:US
Practice Address - Phone:208-882-8159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-4534101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty