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NPI Code Detail

MEDICARE: SHANA RUBERSTEIN LMSW

MEDICARE: SHANA RUBERSTEIN LMSW
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1881143717
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANA RUBERSTEIN LMSW
Provider Business Mailing Address
First Line : 2150 GENERAL PERSHING STREET
Second Line :
City : MANDEVILLE
State : LA
Zip : 70448
Country : US
Telephone Number : 985-674-5155
Fax Number :
Provider Business Practice Location Address
First Line : 2150 GENERAL PERSHING ST
Second Line :
City : MANDEVILLE
State : LA
Zip : 70448-5125
Country : US
Telephone Number : 985-674-5155
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2016
Last Update Date : 10/04/2016

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Directions to “ SHANA RUBERSTEIN LMSW” Practice Location

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