Provider Demographics
NPI:1427752633
Name:RUBLE PSYCHOTHERAPY & CONSULTATION
Entity type:Organization
Organization Name:RUBLE PSYCHOTHERAPY & CONSULTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:971-235-7311
Mailing Address - Street 1:5319 S CORNELL AVE APT 3F
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-5630
Mailing Address - Country:US
Mailing Address - Phone:971-235-7311
Mailing Address - Fax:
Practice Address - Street 1:5319 S CORNELL AVE APT 3F
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-5630
Practice Address - Country:US
Practice Address - Phone:971-235-7311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health