Provider Demographics
NPI:1750899951
Name:RUBIO, RAOUL (LPC)
Entity type:Individual
Prefix:MR
First Name:RAOUL
Middle Name:
Last Name:RUBIO
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5619 BONHAM PATH
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-5855
Mailing Address - Country:US
Mailing Address - Phone:210-464-7404
Mailing Address - Fax:
Practice Address - Street 1:4606 CENTERVIEW STE 263
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-1214
Practice Address - Country:US
Practice Address - Phone:210-464-7404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-22
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75310101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional