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General NPI Number Information
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NPI Number | 1801449822
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Entity Type | Organization
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Legal Business Name | LAURA RABINOVITZ, LICSW, PLC
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Dates
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Enumeration Date | 07/18/2019
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Last Update Date | 07/18/2019
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Provider Practice Location Address
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Address Line | 28 HOWARD ST STE 205
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City | BURLINGTON
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State | VT
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Zip | 05401-0404
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Country | US
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Telephone | 802-238-5071
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Fax |
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Provider Business Mailing Address
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Address Line | 95 LYMAN AVE
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City | BURLINGTON
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State | VT
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Zip | 05401-5051
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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 | CLINICAL SOCIAL WORKER
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Name | LAURA RABINOVITZ
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Credential | LICSW
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Telephone | 802-238-5071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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