Healthcare Provider Details
I. General information
NPI: 1346968815
Provider Name (Legal Business Name): RUBERTI COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/19/2022
Last Update Date: 08/19/2022
Certification Date: 08/19/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
525 S 4TH ST STE 477
PHILADELPHIA PA
19147-1582
US
IV. Provider business mailing address
525 S 4TH ST STE 477
PHILADELPHIA PA
19147-1582
US
V. Phone/Fax
- Phone: 215-330-5830
- Fax:
- Phone: 215-592-4145
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTINE
BRUNING
Title or Position: OWNER
Credential: LPC
Phone: 609-992-4989