Provider Demographics
NPI:1861445744
Name:JUBERT, RODNEY JOSEPH (LCSW-R)
Entity Type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:JOSEPH
Last Name:JUBERT
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MACK RD
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-2713
Mailing Address - Country:US
Mailing Address - Phone:914-475-5129
Mailing Address - Fax:
Practice Address - Street 1:202 HOOKER AVE
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-3329
Practice Address - Country:US
Practice Address - Phone:914-475-5129
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0726851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical