Provider Demographics
NPI:1801869011
Name:RUBIN, KAREN BROWN (PHD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:BROWN
Last Name:RUBIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 A UNION RD
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054
Mailing Address - Country:US
Mailing Address - Phone:704-861-0271
Mailing Address - Fax:704-861-0374
Practice Address - Street 1:1530 A UNION RD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054
Practice Address - Country:US
Practice Address - Phone:704-861-0271
Practice Address - Fax:704-861-0374
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC676103T00000X
NC288106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1467409391OtherJOHN W. LONG, PH.D. PC
NC249030AMedicare PIN