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General NPI Number Information
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NPI Number | 1548754443
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Entity Type | Organization
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Legal Business Name | BETH RUBIN THERAPY LTD.
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Dates
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Enumeration Date | 06/14/2018
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 1717 W SCHUBERT AVE
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City | CHICAGO
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State | IL
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Zip | 60614-2993
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Country | US
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Telephone | 312-967-6272
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Fax |
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Provider Business Mailing Address
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Address Line | 1717 W SCHUBERT AVE
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City | CHICAGO
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State | IL
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Zip | 60614-2993
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Country | US
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Telephone | 312-967-6272
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | BETH RACHEL RUBIN
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Credential | LCSW
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Telephone | 312-967-6272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 149.016573
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License Number State | IL
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