Healthcare Provider Details

I. General information

NPI: 1609274653
Provider Name (Legal Business Name): STEVE RUBIN LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2014
Last Update Date: 01/02/2020
Certification Date: 01/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6810 NORTH STATE ROAD 7
COCONUT CREEK FL
33073
US

IV. Provider business mailing address

6810 NORTH STATE ROAD 7
COCONUT CREEK FL
33073
US

V. Phone/Fax

Practice location:
  • Phone: 561-843-5362
  • Fax:
Mailing address:
  • Phone: 561-843-5362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberISW8377
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW13356
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: