Provider Demographics
NPI:1700535150
Name:RUBIN, EMILY (LICSW)
Entity type:Individual
Prefix:PROF
First Name:EMILY
Middle Name:
Last Name:RUBIN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 RIGGS POINT RD
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-1738
Mailing Address - Country:US
Mailing Address - Phone:978-430-3670
Mailing Address - Fax:
Practice Address - Street 1:6 RIGGS POINT RD
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-1738
Practice Address - Country:US
Practice Address - Phone:978-430-3670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-22
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1241261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical