Provider Demographics
NPI:1417109893
Name:RUBINSTEIN WALLACH, KAREE (MA, LCPC, LPCC)
Entity Type:Individual
Prefix:MRS
First Name:KAREE
Middle Name:
Last Name:RUBINSTEIN WALLACH
Suffix:
Gender:F
Credentials:MA, LCPC, LPCC
Other - Prefix:
Other - First Name:KAREE
Other - Middle Name:B
Other - Last Name:RUBINSTEIN WALLACH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:20 WHITE OAK WAY
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94949-7227
Mailing Address - Country:US
Mailing Address - Phone:847-971-8810
Mailing Address - Fax:
Practice Address - Street 1:20 WHITE OAK WAY
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94949-7227
Practice Address - Country:US
Practice Address - Phone:847-971-8810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180002960101YP2500X
CALPCC8590101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional