Provider Demographics
NPI:1568149276
Name:RUBIN, ALEXIS (LCSW)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:RUBIN
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 1:7100 MASTERS DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3845
Mailing Address - Country:US
Mailing Address - Phone:202-309-3681
Mailing Address - Fax:
Practice Address - Street 1:5454 WISCONSIN AVE STE 1275
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6933
Practice Address - Country:US
Practice Address - Phone:240-743-4535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-04
Last Update Date:2023-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500798691041C0700X
MD141591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical