Provider Demographics
NPI:1376033696
Name:DAVID RAJABIUN & ASSOCIATES COUNSELING LLC
Entity Type:Organization
Organization Name:DAVID RAJABIUN & ASSOCIATES COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAJABIUN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:401-636-0729
Mailing Address - Street 1:652 GEORGE WASHINGTON HWY UNIT 400
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-4267
Mailing Address - Country:US
Mailing Address - Phone:401-636-0729
Mailing Address - Fax:401-334-1833
Practice Address - Street 1:652 GEORGE WASHINGTON HWY UNIT 400
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-4267
Practice Address - Country:US
Practice Address - Phone:401-636-0729
Practice Address - Fax:401-334-1833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-11
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW015441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty