Provider Demographics
NPI:1245612761
Name:RUBIN, DANIEL MAXWELL (LPC, LMHC)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:MAXWELL
Last Name:RUBIN
Suffix:
Gender:M
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1948 E SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-1479
Mailing Address - Country:US
Mailing Address - Phone:404-759-0351
Mailing Address - Fax:
Practice Address - Street 1:1881 NE 26TH ST STE 201A
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33305-1427
Practice Address - Country:US
Practice Address - Phone:561-262-3207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-20
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008469101YP2500X
FLMH16831101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional