Active NPI
Ellena Vanessa Rubinstein, LCMHC
- Mental Health Counselor
- Clemmons, NC
National Provider Identifier
1760808208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 19244
- Practice address
- 2235 Lewisville Clemmons Rd Ste a
Clemmons, NC 27012-9342 - Phone
- (336) 722-7266
- Fax
- (336) 201-0538
- NPI assigned
- Mar 7, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 5600 | SC | |
| Mental Health Counselor | 101YM0800X | 19244 | NC | Primary |
Addresses
Primary practice location
2235 Lewisville Clemmons Rd Ste a
Clemmons, NC 27012-9342
Mailing address
713 S Marshall St
Winston Salem, NC 27101-5808
Phone (336) 722-7266
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19244 | NC | MD | Mental Health Counselor |
| 5600 | SC | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mood Treatment Center, PLLC | Single Specialty | Current | Accepting new patients |
| Complete Care Partners LLC | Single Specialty | Past | Accepting new patients |
Locations
2235 Lewisville Clemmons Rd
Ste A
Clemmons, NC 27012
Phone (336) 408-6917
713 S Marshall St
Winston Salem, NC 27101
Phone (336) 831-3738
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696550400000",
"number": "1760808208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "713 S MARSHALL ST",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271015808",
"telephone_number": "336-722-7266",
"fax_number": "336-201-0538"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2235 LEWISVILLE CLEMMONS RD STE A",
"city": "CLEMMONS",
"state": "NC",
"postal_code": "270129342",
"telephone_number": "336-722-7266",
"fax_number": "336-201-0538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUBINSTEIN",
"first_name": "ELLENA",
"middle_name": "VANESSA",
"credential": "LCMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-07",
"last_updated": "2023-10-06",
"certification_date": "2023-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "SC",
"license": "5600",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "19244",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clemmons, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.