Healthcare Provider Details

I. General information

NPI: 1225867120
Provider Name (Legal Business Name): RUBEDO COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1807 2ND ST STE 80
SANTA FE NM
87505-3541
US

IV. Provider business mailing address

1950 HOPI RD
SANTA FE NM
87505-3311
US

V. Phone/Fax

Practice location:
  • Phone: 973-356-4232
  • Fax:
Mailing address:
  • Phone: 973-356-4232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DIANA LANGBERG
Title or Position: CEO, OWNER, PSYCHOTHERAPIST
Credential:
Phone: 973-356-4232