Healthcare Provider Details

I. General information

NPI: 1710824503
Provider Name (Legal Business Name): ANGELICA RUBIO LCSW PSYCHOTHERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 ANGELICA CT
WEST BABYLON NY
11704-8501
US

IV. Provider business mailing address

3 ANGELICA CT
WEST BABYLON NY
11704-8501
US

V. Phone/Fax

Practice location:
  • Phone: 347-486-9300
  • Fax:
Mailing address:
  • Phone: 347-486-9300
  • 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: ANGELICA RUBIO
Title or Position: PRESIDENT
Credential: RUBIO
Phone: 347-486-9300