Provider Demographics
NPI:1225255284
Name:RUBIN, MARIANN ARCARI
Entity Type:Individual
Prefix:MRS
First Name:MARIANN
Middle Name:ARCARI
Last Name:RUBIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIANN
Other - Middle Name:
Other - Last Name:ARCARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:11309 E PETRA AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-1981
Mailing Address - Country:US
Mailing Address - Phone:480-380-6248
Mailing Address - Fax:480-986-2618
Practice Address - Street 1:7254 E SOUTHERN AVE
Practice Address - Street 2:SUITE 123
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-2786
Practice Address - Country:US
Practice Address - Phone:480-380-6248
Practice Address - Fax:480-986-2618
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ115661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ107699734OtherUNITED HEALTHCARE
AZ12042OtherVALUE OPTIONS
AZ204432OtherMHN
AZ2016596OtherCIGNA
AZ12042OtherVALUE OPTIONS