MEDICARE: MS. ROBIN RUKIN LPC

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	101YM0800X	Mental Health Counselor	0701002829	VA
2	101YP2500X	Professional Counselor	0701002829	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	289555	OTHER	VA	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700834447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROBIN RUKIN LPC

Provider Business Mailing Address
First Line	:	580 CITY CENTER BLVD STE 5
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23606-1880
Country	:	US
Telephone Number	:	804-207-6737
Fax Number	:

Provider Business Practice Location Address
First Line	:	580 CITY CENTER BLVD STE 5
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23606-1880
Country	:	US
Telephone Number	:	804-207-6737
Fax Number	:

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

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	04/15/2025

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