Provider Demographics
NPI:1477448223
Name:RUBELMAN, AMANDA (LLPC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:RUBELMAN
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4783 BATH RD
Mailing Address - Street 2:
Mailing Address - City:BANCROFT
Mailing Address - State:MI
Mailing Address - Zip Code:48414-9762
Mailing Address - Country:US
Mailing Address - Phone:989-413-3795
Mailing Address - Fax:
Practice Address - Street 1:1520 RAMBLEWOOD DR
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-7398
Practice Address - Country:US
Practice Address - Phone:517-247-4624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451024377101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health