Provider Demographics
NPI:1811600174
Name:RUBIN, SHEVA (LMSW)
Entity type:Individual
Prefix:
First Name:SHEVA
Middle Name:
Last Name:RUBIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:SHAVY
Other - Middle Name:
Other - Last Name:SIMCHA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:1147 54TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-4138
Mailing Address - Country:US
Mailing Address - Phone:917-445-0052
Mailing Address - Fax:
Practice Address - Street 1:4102 13TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-1389
Practice Address - Country:US
Practice Address - Phone:718-400-9988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1181261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical