Provider Demographics
NPI:1487737169
Name:RUBINOV, LUDMILLA (LCSW)
Entity type:Individual
Prefix:
First Name:LUDMILLA
Middle Name:
Last Name:RUBINOV
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 HASTINGS ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235
Mailing Address - Country:US
Mailing Address - Phone:917-291-2191
Mailing Address - Fax:
Practice Address - Street 1:57 SAINT MARKS PLACE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-982-3470
Practice Address - Fax:212-477-0521
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0771511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical