=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710824503
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANGELICA RUBIO LCSW PSYCHOTHERAPY PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/30/2026
-----------------------------------------------------
Last Update Date | 04/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3 ANGELICA CT
-----------------------------------------------------
City | WEST BABYLON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11704-8501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-486-9300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3 ANGELICA CT
-----------------------------------------------------
City | WEST BABYLON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11704-8501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-486-9300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | ANGELICA RUBIO
-----------------------------------------------------
Credential | RUBIO
-----------------------------------------------------
Telephone | 347-486-9300
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------