Provider Demographics
NPI:1649488602
Name:RUBENSTEIN, DEBORAH PAULINE (MSW, LICSW, LCSW-C)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:PAULINE
Last Name:RUBENSTEIN
Suffix:
Gender:F
Credentials:MSW, LICSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 COLBY AVE
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-5850
Mailing Address - Country:US
Mailing Address - Phone:301-891-2071
Mailing Address - Fax:
Practice Address - Street 1:4125 ALBEMARLE ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-2105
Practice Address - Country:US
Practice Address - Phone:202-895-0249
Practice Address - Fax:202-895-0245
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3028761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
719285Medicare ID - Type Unspecified