Provider Demographics
NPI:1447494117
Name:RUBEL, HEDY (MSW)
Entity type:Individual
Prefix:MRS
First Name:HEDY
Middle Name:
Last Name:RUBEL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MRS
Other - First Name:HEDY
Other - Middle Name:
Other - Last Name:RUBEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:125 WINCHESTER PL
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1337
Mailing Address - Country:US
Mailing Address - Phone:516-239-0076
Mailing Address - Fax:
Practice Address - Street 1:125 WINCHESTER PL
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-1337
Practice Address - Country:US
Practice Address - Phone:516-239-0076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-26
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0782631104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker