Daniel Ruseborn, LMFT, LMHC, CSAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CSAC1715-12 Issued in HI

Practice address

1 Jarrett White Rd
Tripler Army Medical Center, HI 96859-5001

Phone

(808) 433-1389

NPI assigned

Nov 21, 2017

Last updated

Sep 14, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1467966838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "city": "TRIPLER ARMY MEDICAL CENTER",
            "state": "HI",
            "postal_code": "968595001",
            "telephone_number": "808-433-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "city": "TRIPLER ARMY MEDICAL CENTER",
            "state": "HI",
            "postal_code": "968595001",
            "telephone_number": "808-433-1389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSEBORN",
        "first_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "LMFT, LMHC, CSAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-21",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "HI",
            "license": "CSAC1715-12",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "HI",
            "license": "LMHC363",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "HI",
            "license": "MFT-569",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "VAD000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arleen Ronquillo, M.S., PA-C
• Christopher John Rosemeyer, D.O.
• Lee Ken Rousslang
• Joydip Roy, MD
• Bryan Royal
• Catherine Rutledge, M.D.
• Brenna Jean Ryan, DO
• Jenny Ryan, MD
• Alivia Leigh Sabatino, MD
• Ceyda Sablak

• Addiction (Substance Use Disorder) Counselor in Tripler Army Medical Center, HI
• Providers in Tripler Army Medical Center, HI by specialty
• Addiction (Substance Use Disorder) Counselor in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.