Provider Demographics
NPI:1467538538
Name:RUBOW, KARINA MEGNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KARINA
Middle Name:MEGNE
Last Name:RUBOW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9538 BAY POINT DR
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-2050
Mailing Address - Country:US
Mailing Address - Phone:757-321-2422
Mailing Address - Fax:
Practice Address - Street 1:825 CRAWFORD PKWY
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-2301
Practice Address - Country:US
Practice Address - Phone:757-391-6557
Practice Address - Fax:757-391-6560
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040039451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7713223Medicaid
VA8932140Medicaid
VA8923264Medicaid