Active NPI
Brent Allen Ruebensam, , M.A., LPC, ASOTP
- Professional Counselor
- Lubbock, TX
National Provider Identifier
1528765310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 85943
- Practice address
- 2511 63Rd St
Lubbock, TX 79413-5819 - Phone
- (312) 560-4874
- NPI assigned
- Feb 13, 2023
- Last updated
- Feb 13, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 85943 | TX | Primary |
Addresses
Primary practice location
2511 63Rd St
Lubbock, TX 79413-5819
Mailing address
2511 63Rd St
Lubbock, TX 79413-5819
Phone (312) 560-4874
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676246400000",
"number": "1528765310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2511 63RD ST",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794135819",
"telephone_number": "312-560-4874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2511 63RD ST",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794135819",
"telephone_number": "312-560-4874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUEBENSAM",
"first_name": "BRENT",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"credential": ", M.A., LPC, ASOTP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-02-13",
"last_updated": "2023-02-13",
"certification_date": "2023-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "85943",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.