Provider Demographics
NPI:1548754443
Name:BETH RUBIN THERAPY LTD.
Entity Type:Organization
Organization Name:BETH RUBIN THERAPY LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:RACHEL
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:312-967-6272
Mailing Address - Street 1:901 W MADISON ST UNIT 719
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-3374
Mailing Address - Country:US
Mailing Address - Phone:312-967-6272
Mailing Address - Fax:
Practice Address - Street 1:901 W MADISON ST UNIT 719
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-3374
Practice Address - Country:US
Practice Address - Phone:312-967-6272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-14
Last Update Date:2021-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.016573261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)