Provider Demographics
NPI:1306061007
Name:RUBINSTEIN, VIVIANA ESTELA (LMHC)
Entity type:Individual
Prefix:MRS
First Name:VIVIANA
Middle Name:ESTELA
Last Name:RUBINSTEIN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 COURT NORTH DR
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-8107
Mailing Address - Country:US
Mailing Address - Phone:631-270-4711
Mailing Address - Fax:
Practice Address - Street 1:ST. JOHN'S EPISCOPAL HOSPITAL, CMHC
Practice Address - Street 2:521 BEACH 20TH STREET
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691
Practice Address - Country:US
Practice Address - Phone:718-869-8822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002986101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY002986OtherLMHC