Active NPI
Barry Rubin, LCSW
- Clinical Social Worker
- Stratford, CT
National Provider Identifier
1831107382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 13601
- Practice address
- 75 Longview Dr
Stratford, CT 06614-1396 - Phone
- (207) 974-6090
- NPI assigned
- Aug 3, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC702 | ME | |
| Clinical Social Worker | 1041C0700X | 13601 | CT | Primary |
Addresses
Primary practice location
75 Longview Dr
Stratford, CT 06614-1396
Mailing address
75 Longview Dr
Stratford, CT 06614-1396
Phone (207) 974-6090
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 223450199 | Medicaid | ME |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC702 | ME | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705363200000",
"number": "1831107382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 LONGVIEW DR",
"city": "STRATFORD",
"state": "CT",
"postal_code": "066141396",
"telephone_number": "207-974-6090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 LONGVIEW DR",
"city": "STRATFORD",
"state": "CT",
"postal_code": "066141396",
"telephone_number": "207-974-6090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUBIN",
"first_name": "BARRY",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-03",
"last_updated": "2024-01-16",
"certification_date": "2024-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC702",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "13601",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "223450199",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stratford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.