MEDICARE: WHITNEY RUBLE LSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	1501411	OH

General Provider Information

NPI Number	:	1013415587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WHITNEY RUBLE LSW

Provider Business Mailing Address
First Line	:	7 HANSBRINKER CT
Second Line	:
City	:	LIBERTY TOWNSHIP
State	:	OH
Zip	:	45044-9737
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 HANSBRINKER CT
Second Line	:
City	:	LIBERTY TOWNSHIP
State	:	OH
Zip	:	45044-9737
Country	:	US
Telephone Number	:	513-868-7700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2018
Last Update Date	:	01/30/2018

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Directions to “ WHITNEY RUBLE LSW” Practice Location

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