Healthcare Provider Details

I. General information

NPI: 1366120263
Provider Name (Legal Business Name): ROCHELLE KRUBITSKY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 07/12/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 MAPLE AVE # 104
RED BANK NJ
07701-1764
US

IV. Provider business mailing address

4 VANCLEVE RD
MANALAPAN NJ
07726-7935
US

V. Phone/Fax

Practice location:
  • Phone: 732-660-5642
  • Fax:
Mailing address:
  • Phone: 732-660-5642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC01257400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: