Provider Demographics
NPI:1912540121
Name:RUBENSTEIN, ALEXIS (LMSW)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:RUBENSTEIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 WEST 124TH STREET
Mailing Address - Street 2:6TH FLOOR BILLING DEPT
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-4575
Mailing Address - Country:US
Mailing Address - Phone:212-949-4831
Mailing Address - Fax:212-682-2613
Practice Address - Street 1:910 E 172ND ST FL 3
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-5802
Practice Address - Country:US
Practice Address - Phone:347-767-2200
Practice Address - Fax:212-682-2613
Is Sole Proprietor?:No
Enumeration Date:2019-10-21
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY107755104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker