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General NPI Number Information
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NPI Number | 1528827920
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Entity Type | Individual
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Provider Name | GINO RUBENS LMHC, LPC
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Gender | Male
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Dates
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Enumeration Date | 03/18/2024
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 3683 S INDUSTRIAL DR
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City | SIMPSONVILLE
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State | SC
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Zip | 29681-3238
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Country | US
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Telephone | 954-296-9924
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Fax |
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Provider Business Mailing Address
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Address Line | 858 BARLOW LN
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City | WOODRUFF
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State | SC
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Zip | 29388-8044
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 10186
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License Number State | SC
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