Provider Demographics
NPI:1184090086
Name:RUBIN COUNSELING, LLC.
Entity type:Organization
Organization Name:RUBIN COUNSELING, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:MAXWELL
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, MAC, NCC
Authorized Official - Phone:770-759-0351
Mailing Address - Street 1:1740 CENTURY CIR NE APT 1253
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-3044
Mailing Address - Country:US
Mailing Address - Phone:404-759-0351
Mailing Address - Fax:
Practice Address - Street 1:3455 LAWRENCEVILLE SUWANEE RD STE D
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6425
Practice Address - Country:US
Practice Address - Phone:770-759-0351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-13
Last Update Date:2015-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA507744251S00000X
GALPC008469251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1245612761Medicaid
1245612761Medicare Oscar/Certification
GA1245612761Medicare NSC
GA1245612761Medicaid
GA1245612761Medicare UPIN