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NPI Code Detail

MEDICARE: ROBIN ADDELL RUDIC LCSW

MEDICARE: ROBIN ADDELL RUDIC LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCW013180PA
2103TS0200XSchool Psychologist3783803AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100664199OTHERPAHIGHMARK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235111675
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBIN ADDELL RUDIC LCSW
Provider Business Mailing Address
First Line : 7990 E SNYDER RD
Second Line : 2104
City : TUCSON
State : AZ
Zip : 85750-6530
Country : US
Telephone Number : 520-760-0482
Fax Number : 520-760-0482
Provider Business Practice Location Address
First Line : 1010 E 10TH ST
Second Line :
City : TUCSON
State : AZ
Zip : 85719-5813
Country : US
Telephone Number : 520-225-6410
Fax Number : 520-225-6410
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2005
Last Update Date : 09/11/2025

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Directions to “ ROBIN ADDELL RUDIC LCSW” Practice Location

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