Active NPI
Stephen Rabeno, PHD, LCSW-R
- Public Health or Welfare Agency
- Port Jefferson Station, NY
National Provider Identifier
1578773156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health or Welfare Agency
- License
- R044363-1
- Practice address
- 1050 Hallock Ave
Port Jefferson Station, NY 11776-1214 - Phone
- (631) 331-8245
- NPI assigned
- May 23, 2007
- Last updated
- Feb 26, 2013
- 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 |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | R044363-1 | NY | Primary |
Addresses
Primary practice location
1050 Hallock Ave
Port Jefferson Station, NY 11776-1214
Mailing address
1 High St.
Port Jefferson, NY 11777
Phone (631) 928-2377
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R044363-1 | NY | MD | Public Health or Welfare Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361836800000",
"number": "1578773156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 HIGH ST.",
"city": "PORT JEFFERSON",
"state": "NY",
"postal_code": "11777",
"telephone_number": "631-928-2377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 HALLOCK AVE",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "117761214",
"telephone_number": "631-331-8245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RABENO",
"first_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "PHD, LCSW-R",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-23",
"last_updated": "2013-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "251K00000X",
"taxonomy_group": "",
"desc": "Public Health or Welfare",
"state": "NY",
"license": "R044363-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Jefferson Station, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.